- ICH GCP
- Registro de ensayos clínicos de EE. UU.
- Ensayo clínico NCT00419315
A Randomized Clinical Trial of Alcohol Care Management
Primary Care Based Disease Management for Alcohol Dependence
Descripción general del estudio
Estado
Condiciones
Intervención / Tratamiento
Descripción detallada
Background: Alcohol dependence is one of the leading causes of disability worldwide. Despite the availability of efficacious treatments less than 20% of individuals with alcohol dependence are actively engaged in treatment. Within the VA system systematic screening was implemented to increase the identification of patients with both abuse and dependence. However, there continues to be a marked discrepancy in the care offered or accessed among those identified with alcohol dependence. Existing treatment guidelines suggest that all persons with dependence receive care in specialty addiction treatment. Data from our center indicate that among those individuals screened in primary care who have AUDIT - C scores of >7, only 30% are formally evaluated with 50% receiving only brief advice and 20% having no evidence of assessment or referral. Of those assessed and referred to specialty care only 60% attend an initial visit and only 33% meet the EPRP performance measure of 2 visits per month for 90 days. This disparity in treatment access exists even though Veterans self report a desire to cut down and readiness to change drinking behaviors. (VA ACQUIP) and a willingness to consider pharmacotherapy.
Aims: Available evidence suggests that primary care may be a key component in the identification of alcohol dependent patients, delivery of initial interventions, and to the success of addiction treatment. Indeed, the vast majority of screening and new case identification occurs within primary care. The primary aims of this proposal are to test the effectiveness of a primary care based Alcohol Care Management (ACM) program and to evaluate the barriers and facilitators to accessing and engaging individuals into treatment. The ACM program uses a Behavioral Health Specialist to deliver care focused on the use of pharmacotherapy in combination with psychosocial support (Medication Management). This model may overcome barriers to care such as frequent intensive visit schedules often required in specialty settings, stigma associated with specialty care or group therapy approaches, access to specialty care in remote areas, and the current focus on a 12 step model of treatment. Secondary aims are to establish the acceptability of primary care based treatments and defining treatment modifiers such as age, barriers, co-occurring depression, and pharmacogenetic response.
Tipo de estudio
Inscripción (Actual)
Fase
- Fase 4
Contactos y Ubicaciones
Ubicaciones de estudio
-
-
New York
-
Syracuse, New York, Estados Unidos, 13210
- Syracuse VA Medical Center, Syracuse, NY
-
-
Pennsylvania
-
Philadelphia, Pennsylvania, Estados Unidos, 19104
- Philadelphia VA Medical Center, Philadelphia, PA
-
-
Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Géneros elegibles para el estudio
Descripción
Inclusion Criteria:
- be men and women = 18 years of age;
- meet criteria for alcohol dependence;
- drink more than an average of 2 drinks per day prior to study entry (over the last 60 days);
- have adequate hearing to participate in assessment
Exclusion Criteria:
- show no evidence of current abuse or dependence of illicit substances other than marijuana;
- no current hallucinations;
- no current symptoms of mania;
- be relatively cognitively intact
- not actively participate in specialized addition or behavioral health treatment within the prior 12 months
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Único
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
---|---|
Experimental: Alcohol Care Management
Care management for alcohol dependence delivered in primary care
|
Care management for alcohol dependence with a focus on pharmacotherapy
|
Comparador activo: Usual Care
Usual care included a referral to specialty addiction treatment
|
Usual care included a referral to a specialty addiction treatment program.
|
¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
---|---|---|
Treatment Engagement
Periodo de tiempo: 6 months
|
This measured the percentage of subjects who attended at least 2 clinical addiction sessions in a given month.
The outcome presented is the percentage during the 6th month of the trial.
|
6 months
|
Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
---|---|---|
Percent Days of Heavy Alcohol Use
Periodo de tiempo: 6 months
|
This is a measure during the 6 month of the percentage of 30 days in which a subject had at least 1 day of heavy drinking as defined by drinking more than 4 standard drinks in a day (3 or more for women).
|
6 months
|
Colaboradores e Investigadores
Patrocinador
Investigadores
- Investigador principal: David W. Oslin, MD, Philadelphia VA Medical Center, Philadelphia, PA
Publicaciones y enlaces útiles
Publicaciones Generales
- Oslin DW, Lynch KG, Maisto SA, Lantinga LJ, McKay JR, Possemato K, Ingram E, Wierzbicki M. A randomized clinical trial of alcohol care management delivered in Department of Veterans Affairs primary care clinics versus specialty addiction treatment. J Gen Intern Med. 2014 Jan;29(1):162-8. doi: 10.1007/s11606-013-2625-8. Epub 2013 Sep 20. Erratum In: J Gen Intern Med. 2016 Apr;31(4):449.
- Rotenberg JR, Leong SH, Maisto SA, McKay JR, Possemato K, Ingram E, Oslin DW. Post-intervention Durability of Alcohol Care Management: 1-Year Follow-up of a Randomized Controlled Trial. J Gen Intern Med. 2018 Oct;33(10):1626-1628. doi: 10.1007/s11606-018-4567-7. No abstract available.
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio
Finalización primaria (Actual)
Finalización del estudio (Actual)
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Estimar)
Actualizaciones de registros de estudio
Última actualización publicada (Estimar)
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- IIR 06-058
Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .
Ensayos clínicos sobre Dependencia al alcohol
-
Charles Drew University of Medicine and ScienceRetiradoConsumo de alcohol | Trastorno por consumo de alcohol | Abuso de alcohol | Problema de alcohol
-
Karolinska InstitutetTerminadoConsumo de alcohol | Dependencia al alcohol | Alcohol; Uso nocivo | Trastorno por consumo de alcohol | Abuso de alcoholSuecia
-
Boston Medical CenterBoston University; National Institute on Alcohol Abuse and Alcoholism (NIAAA)TerminadoDependencia al alcohol | Abuso de alcohol | Uso no saludable de alcohol | Cantidades peligrosas de consumo de alcohol | Uso peligroso de alcoholEstados Unidos
-
Karolinska InstitutetRegion StockholmTerminadoDependencia al alcohol | Trastorno por consumo de alcohol | Abuso de alcohol | Uso nocivo de alcoholSuecia
-
University of Auckland, New ZealandTe Hiringa Hauora/Health Promotion AgencyTerminadoBebiendo alcohol | Consumo, AlcoholNueva Zelanda
-
Karolinska InstitutetRegion Stockholm; Public Health Agency of SwedenTerminadoTratamiento anónimo en Internet para la dependencia del alcohol: un ensayo aleatorizado y controladoDependencia al alcohol | Trastorno por consumo de alcohol | Abuso de alcohol | Uso nocivo de alcoholSuecia
-
University of Central FloridaInscripción por invitación
-
HBSAReclutamientoConsumo excesivo de alcohol, consumo de alcohol por menores de edad, beber y conducir, daños relacionados con el alcoholEstados Unidos
-
University of ThessalyEuropean Social FundTerminadoDependencia al alcohol | Trastorno por consumo de alcohol | Consumo excesivo de alcohol | Abuso de alcohol
-
University of WashingtonNational Institute on Alcohol Abuse and Alcoholism (NIAAA)Activo, no reclutandoAlcohol; uso, problemaEstados Unidos
Ensayos clínicos sobre Alcohol Care Management
-
Silke Wiegand-Grefe, Prof. Dr.Charite University, Berlin, Germany; Hannover Medical School; University Hospital... y otros colaboradoresActivo, no reclutandoEnfermedades rarasAlemania
-
Baylor College of MedicineReclutamientoDesórdenes de ansiedad | Trastornos por uso de sustanciasEstados Unidos
-
George Washington UniversityTranscultural Psychosocial Organization NepalTerminado
-
Rema AfifiReclutamientoEstrés Psicológico | Salud mentalLíbano
-
Klimmendaal RevalidatiespecialistenReclutamientoLesión cerebral adquirida | Disfunción ejecutiva | Capacitación en gestión de objetivos | Capacitación en estrategia compensatoria | Juegos seriosPaíses Bajos
-
Brigham and Women's HospitalTerminadoInsomnio al inicio del sueñoEstados Unidos
-
Elizabeth Glaser Pediatric AIDS FoundationUnited States Agency for International Development (USAID); Ministry of Health...TerminadoInfecciones por VIHSuazilandia
-
University Health Network, TorontoReclutamientoLinfoma | Trastornos linfoproliferativos | Etapa I del cáncer de mama | Cáncer de mama en estadio II | Cáncer colorrectal en estadio II | Cáncer colorrectal en estadio III | Etapa III del cáncer de mama | Cáncer colorrectal Etapa I | Cáncer de cabeza y cuello estadio III | Cáncer de mama, estadio 0 | Cáncer... y otras condicionesCanadá
-
KintoAlzheimer's AssociationTerminadoDemencia | Enfermedad de Alzheimer | Enfermedad de cuerpos de Lewy | Demencia frontotemporal | Demencia vascular | Demencia mixtaEstados Unidos
-
Emory UniversityFoundation for Physical Therapy, Inc.Terminado