Developing a Telehealth Model to Improve Treatment Access for Rural Veterans With Substance Use Disorders (VetReach)

Using Telehealth to Expand Treatment Access for Veterans With Opioid Use Disorder (CDA 18-008)

This project will pilot-test and obtain stakeholder input on a telehealth-delivered substance use disorder (SUD) care model (with initial engagement and ongoing MI-CBT treatment) with the goal of increasing treatment utilization and improving outcomes for rural and non-rural Veterans with SUDs.

Study Overview

• Status: Recruiting
• Conditions: Substance Use; Substance Use Disorders; Substance Dependence; Veterans
• Intervention / Treatment: Behavioral: VetReach

• Study Type: Interventional
• Enrollment (Estimated): 100
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Deborah A Manderachia, MSW; Phone Number: (734) 222-7424; Email: deborah.manderachia@va.gov
• Study Contact Backup: Name: Carly Brin, MSW; Phone Number: (734) 769-7100; Email: brinca@med.umich.edu

Study Locations

• United States
  • Michigan
    • Ann Arbor, Michigan, United States, 48105-2303
      • Recruiting
      • VA Ann Arbor Healthcare System, Ann Arbor, MI
      • Contact: Carly Brin, MSW; Phone Number: (734) 769-7100; Email: brinca@med.umich.edu
      • Contact: Deborah A Manderachia, MSW; Phone Number: 734-222-7424; Email: deborah.manderachia@va.gov
      • Principal Investigator: Lewei Lin, MD
      • Sub-Investigator: Mark A. Ilgen, PhD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 70 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Veteran patients at the Ann Arbor VA Healthcare System
• Diagnostic and Statistical Manual of Mental Disorders (DSM-5) SUD diagnosis and/or substance use on average of 2 days a week over the past month
• Telephone access
• Able to provide informed consent

Exclusion Criteria:

• Receiving SUD psychotherapy
• Inability to speak or understand English
• Substantial mental health instability or conditions that preclude informed consent (e.g., acute psychosis, cognitive deficits) or understanding of assessment or program content
• Prior alcohol withdrawal seizures or delirium tremens

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: MI-CBT Teletx; The intervention consists of an initial 30-60 min phone-delivered Engagement session that focuses on MI to help participants build self-efficacy and motivation to engage and to empower them to plan change and use Elicit-Provide-Elicit (EPE) to address treatment barriers (e.g., stigma, appeal, accessibility). Participants will then complete up to 8 ~50 minute Teletx weekly sessions via videoconference (or phone if needed). The intervention is highly patient-centered, by meeting and assessing patients where they are including in their unique context (i.e. rural community), helping them identify reasons and motivations for change, and centered around their goals (e.g. substance use reduction or abstinence).

Behavioral: VetReach; Telehealth-delivered MI-CBT substance use disorder care model

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Feasibility of the intervention (engagement)	Percent (%) of participants engaging in the intervention (at least 3 completed sessions)	8 weeks
Acceptability of the telehealth intervention	Study-specific acceptability rating completed by participants (% with a positive rating, higher % is better)	2 months

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in substance consumption	Substance use/consumption will be assessed using the 30-day Timeline Follow-Back (TLFB). The TLFB will capture information on the frequency and quantity of substance use, with total consumption calculated.	baseline, 8 weeks post-baseline
Change in frequency of substance use as reported on the Timeline Follow-Back (TLFB)	Based on frequency and quantity, higher scores indicate worse outcome.	baseline, 8 weeks post-baseline

Collaborators and Investigators

• Sponsor: VA Office of Research and Development
• Collaborators: VA Ann Arbor Healthcare System
• Investigators: Principal Investigator: Lewei Lin, MD, VA Ann Arbor Healthcare System, Ann Arbor, MI

Study record dates

Study Major Dates

• Study Start (Actual): May 19, 2022
• Primary Completion (Estimated): September 30, 2026
• Study Completion (Estimated): September 30, 2026

Study Registration Dates

• First Submitted: April 21, 2022
• First Submitted That Met QC Criteria: April 21, 2022
• First Posted (Actual): April 27, 2022

Study Record Updates

• Last Update Posted (Actual): September 29, 2023
• Last Update Submitted That Met QC Criteria: September 27, 2023
• Last Verified: September 1, 2023

More Information

Terms related to this study

• Keywords: Motivational Interviewing; Telehealth; Cognitive Behavioral Therapy; Rural Health
• Additional Relevant MeSH Terms: Mental Disorders; Chemically-Induced Disorders; Substance-Related Disorders
• Other Study ID Numbers: CDX 22-007; PROJ-03672 (Other Identifier: VA Ann Arbor Healthcare System)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No