- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03895827
Recovery Initiation and Management After Overdose (RIMO) Experiment (RIMO)
Recovery Initiation and Management After Overdose (RIMO) Experiment: Phase 2 Main Clinical Trial (R33)
Study Overview
Status
Conditions
Detailed Description
Research staff will work with the Chicago Fire Department's Emergency Medical Services division and the Chicago Police Department to identify people who have just had an opioid overdose reversed with naloxone, recruit them into the trial, randomize them to a passive referral (via a brochure) vs. the RIMO experimental group. Using the study recruitment and RIMO procedures refined in Phase 1, a total of 350 individuals will be recruited and randomly assigned to the "referral to MAT" control or to "RIMO". All participants will receive standardized assessments at baseline and 3, 6, and 9 months post-randomization. The study's aims and their associated hypotheses are:
Aim 1: Evaluate RIMO's direct effect on linkage to MAT, length of time on MAT, dropout, and total days of MAT.
H1: Relative to the control group, RIMO will have a direct effect on: a) initiating MAT sooner, b) staying on medication longer, c) reducing dropout, and d) receiving more total days of MAT.
Aim 2: Evaluate RIMO's direct and indirect (via MAT) effects on time to relapse, opioid use, and opioid-related overdose.
H2: RIMO will have direct and indirect (via days of MAT treatment) effects on: a) time to relapse, b) days of opioid use, and c) number of overdoses.
Aim 3: RIMO's direct and indirect (via MAT and opioid use) effects on opioid-related fatalities, opioid use disorder (OUD) symptoms, physical health, mental health and the cost of health care utilization.
H3: RIMO will have direct and indirect (via days of MAT treatment and days of opioid use) effects on: a) opioid-related fatalities, b) opioid use disorders symptoms, c) physical health, d) mental health, and e) cost of health care utilization.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Christy K Scott, Ph.D.
- Phone Number: 312-274-5306
- Email: cscott@chestnut.org
Study Contact Backup
- Name: Michael L Dennis, Ph.D.
- Phone Number: 309-451-7801
- Email: mdennis@chestnut.org
Study Locations
-
-
Illinois
-
Chicago, Illinois, United States, 60610
- Chestnut Health Systems
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- experienced an opioid overdose reversed with naloxone administered by first responders on a participating team within the past week
- not in treatment during the past 30 days
- screen positive for an OUD
Exclusion Criteria:
- under age 18
- unable to speak and understand English
- not residing in Chicago
- cognitively unable to provide informed consent
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Passive Referral Control
Participants will be given information on recently expanded and publicly-funded MAT treatment in their community.
|
Currently neither first responders or emergency department staff regularly refer people to any kind of substance use after an opioid overdose reversal.
In the passive referral condition they will at least get a brochure with information on recently expanded and publicly-funded medication-assisted treatment in their community.
|
Experimental: Recovery Initiation and Management after Overdose (RIMO)
Participants assigned to the RIMO arm will meet with Linkage Managers (LM), who will use motivational interviewing (MI) techniques to: 1) identify the need for treatment and barriers to going, 2) discuss with patients the benefits of their decision to go to treatment, including activities they might enjoy as well as things they do not like about their alcohol/substance use, 3) provide personalized feedback to participants about the status of their condition based on responses to the assessment instruments, 4) help participants resolve ambivalence about their use and move them toward a commitment to change by accessing additional care, 5) address existing barriers to treatment (e.g., childcare, transportation), 6) schedule a treatment appointment, and 7) facilitate medication assisted treatment re-entry and engagement.
|
Currently neither first responders or emergency department staff regularly refer people to any kind of substance use after an opioid overdose reversal.
In the passive referral condition they will at least get a brochure with information on recently expanded and publicly-funded medication-assisted treatment in their community.
RIMO uses motivational interviewing and linkage assistance techniques to get people who have had a recent opioid overdose reversal to go to medication-assisted treatment (MAT), stay in MAT, and, if they drop out, go back to MAT treatment.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
MAT Time to Initiation
Time Frame: 9 months
|
Days from index naloxone administration to the initiation of any kind of MAT, from treatment records.
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9 months
|
Length of Staying on Medication
Time Frame: 9 months
|
Days between MAT initiation and discharge, from treatment records.
|
9 months
|
MAT Days
Time Frame: 9 months
|
Total days of MAT over 9 months from Global Appraisal of Individual Needs Quick (GAIN) and treatment records.
|
9 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Time to Relapse
Time Frame: 9 months
|
Days from randomization to next subsequent use of opioids or heroin based on GAIN follow-up interviews and urine tests.
|
9 months
|
Opioid Days of Use
Time Frame: 9 months
|
Days of opioids and/or heroin use summed over the GAIN follow-up interviews.
|
9 months
|
Opioid Overdose
Time Frame: 9 months
|
Number of opioid-related overdose[s] summed over the GAIN follow-up interviews.
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9 months
|
Opioid-Related Fatality
Time Frame: 9 months
|
Any International Classification of Diseases version 10 (ICD-10) cause of death related to opioid overdose (T40.1,
T40.2, T40.3, T40.4,
T40.6, X42, X44, X62, X64, Y12, Y14) in Centers for Disease Control (CDC) death records.
|
9 months
|
Opioid Use Disorder symptoms
Time Frame: 9 months
|
The Opioid Use Disorder Scale; scores range form 0 to 11 based on a count of self reported symptoms from the Diagnostic and Statistical Manual 5 criteria for opioid use disorder symptoms from the GAIN follow-up interviews.
The scale score is interpreted as subclinical (0-1 symptoms), low (2-3 symptoms), moderate (4-5 symptoms) or high (6-11 symptoms) severity.
|
9 months
|
Physical Health
Time Frame: 9 months
|
The average of 5 past 90-day items on the Health Problem Screener (worried about health, pain, health kept participant from meeting responsibilities) from GAIN follow-up interviews.
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9 months
|
Mental Health: Internalizing Symptoms
Time Frame: 9 months
|
The GAIN's Internalizing Disorder Screener; ranging from 0 to 6, the screener includes symptoms of depression, anxiety, trauma, suicide and are interpreted as low (0 symptoms), moderate (1-2 symptoms) or high (3-6 symptoms)
|
9 months
|
Mental Health: Externalizing Symptoms
Time Frame: 9 months
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The GAIN's Externalizing Disorder Screener; ranging from 0 to 6, the screener includes symptoms of attention deficit, hyperactivity, conduct, gambling disorders and are interpreted as low (0 symptoms), moderate (1-2 symptoms) or high (3-6 symptoms)
|
9 months
|
Cost of Health Care Utilization
Time Frame: 9 months
|
Sum of the quarterly costs of health care from the GAIN-Q3 follow-up interviews; based on the frequency of health, mental health or substance-related emergency department visits, hospitalizations, residential treatment, outpatient surgery, MAT, intensive outpatient, outpatient treatment days/times multiplied by their respective costs using published estimates by health economists, adjusted for inflation using the consumer price index.
|
9 months
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Christine E Grella, Ph.D., Chestnut Health Systems
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 1132-0319
- 1R21DA045774 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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