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Contingency Management of Alcohol Abuse in the Severely Mentally ILL (CMETG)

5 de enero de 2017 actualizado por: Richard Ries, University of Washington

Novel EtG-Based Contingency Management for Alcohol in the Severely Mentally Ill

The investigators will evaluate the efficacy of a comprehensive 12-week contingency management intervention for treating alcohol dependence for persons with severe mental illness who are seen within the context of a community mental health center setting. The primary contingency will be submission of alcohol-free urines. Additional reinforcers will be provided for intensive outpatient addiction treatment attendance. Reinforcers will be vouchers or actual items useful for day-to-day living. Participants will be 120 adults diagnosed with alcohol dependance and severe mental illness.

Descripción general del estudio

Estado

Terminado

Condiciones

Intervención / Tratamiento

Descripción detallada

The contingency management (CM) paradigm that will be used is the variable magnitude of reinforcement procedure. In order to encourage engagement in study procedures and reduce dropout in the randomized sample, all participants will undergo a 4-week pre-randomization induction period. During the induction period, participants will be reinforced for providing urine-tests three times a week. Those who demonstrate study participation and need for treatment during the induction period will be randomized to receive treatment as usual and either 1) 12 weeks of CM for alcohol abstinence (assessed by Ethyl glucuronide immunoassay urine-test) AND weekly reinforcement for intensive outpatient addiction treatment attendance; or 2) 12 weeks of reinforcement for providing urine-samples and continued study involvement. Randomization will be used to assign participants to treatment conditions.

The primary outcome will be changes in alcohol use assessed by Ehyl glucuronide immunoassay urine-tests, breath-tests, as well as self- and clinician-reported alcohol use. The secondary outcome will be changes in intensive outpatient group attendance assessed by intensive outpatient clinician-report, as well as administrative data sources, and self-report. Other outcomes will include: urine-tests and self-reported illicit drug use, psychiatric symptoms, other outpatient treatment utilization, HIV-risk, and nicotine use. All outcomes will be assessed [for 4-weeks prior to study enrollment (self-report, clinician ratings etc)] and throughout the 4-week induction, 12-week intervention, and 3-month follow-up periods.

Tipo de estudio

Intervencionista

Inscripción (Actual)

123

Fase

  • No aplica

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Ubicaciones de estudio

  • Estados Unidos
    • Washington
      • Seattle, Washington, Estados Unidos, 98014
        • Harborview Medical Center

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

18 años a 65 años (Adulto, Adulto Mayor)

Acepta Voluntarios Saludables

No

Géneros elegibles para el estudio

Todos

Descripción

Inclusion Criteria:

  1. Currently receiving psychiatric [AND intensive outpatient addiction treatment] at Community Psychiatric Clinic (CPC).
  2. Aged 18 to 65 years.
  3. Ability to understand written and spoken English language.
  4. DSM-IV diagnosis of alcohol dependence as assessed by the MINI psychiatric interview.
  5. Diagnosis of current serious mental illness: schizophrenia, schizoaffective disorders, bipolar disorder I or II, or recurring major depressive disorders as assessed by the MINI psychiatric interview.
  6. Alcohol use in the month prior to study entry: self-reported alcohol use of 5 days or more during the 30 days prior to study entry (5 drinking days/month is selected based on previous research reporting alcohol use in 18% of days assessed in a sample of psychiatric outpatients with co-occurring SUDs & SMI).120
  7. A CPC treating clinician must affirm the potential participant is safe to participate in the study.

Exclusion Criteria:

  1. A significant risk of dangerous alcohol withdrawal: a history of alcohol detoxification or seizure in the last 12 months AND participant or clinician concern that abstinence will induce dangerous alcohol withdrawal.
  2. DSM-IV diagnosis of current (last year) drug dependence as assessed by the MINI interview.
  3. Any medical/psychiatric condition, or severity of that condition, that in the opinion of the PI, would compromise safe study participation.
  4. Chart defined organic brain disorder or dementia.
  5. Inability to provide informed consent as measured by the University of California San Diego Brief Assessment of Capacity to Consent (UBACC), a tool designed to screen for ability to provide informed consent for research. If indicated by the UBACC screening process, the more comprehensive MacCAT-CR will be used.

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Tratamiento
  • Asignación: Aleatorizado
  • Modelo Intervencionista: Asignación paralela
  • Enmascaramiento: Ninguno (etiqueta abierta)

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Experimental: Contingency Management
Contingency Management plus treatment as usual
Conductual: Contingency Management
Behavioral reinforcement for alcohol abstinence
Sin intervención: Non-contingent control group
Treatment as usual plus reinforcement for attendance

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Alcohol Use as Assessed by Ethyl Glucuronide Detection in Urine
Periodo de tiempo: Over 16 weeks of treatment (repeated measure)
Mean EtG value (in ng/mL). 150ng/mL or above = EtG-positive, 149ng/mL or below = EtG-negative. EtG = ethyl glucuronide, alcohol biomarker detectable in urine.
Over 16 weeks of treatment (repeated measure)

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Change in Intensive Outpatient Substance Abuse Treatment Attendance
Periodo de tiempo: During 16 weeks of treatment
During 16 weeks of treatment
Self Report Drug Use
Periodo de tiempo: through 7 months of study
through 7 months of study
Other Drug Use as Measured by Urinalysis
Periodo de tiempo: through 7 months of study
through 7 months of study
Community Outcomes
Periodo de tiempo: entire study period, and three month prior and after study involvement
(jail bookings, ER visits, mental health and substance abuse service utilization)
entire study period, and three month prior and after study involvement
Psychiatric Symptomology
Periodo de tiempo: throughout 7 months of study
Brief Symptom Inventory; Positive and Negative Symptom Scale
throughout 7 months of study

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

University of Washington

Investigadores

  • Investigador principal: Richard K Ries, MD, University of Washington
  • Investigador principal: Michael McDonell, PhD, Washington State University

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio

1 de marzo de 2012

Finalización primaria (Actual)

1 de febrero de 2015

Finalización del estudio (Actual)

1 de febrero de 2016

Fechas de registro del estudio

Enviado por primera vez

26 de marzo de 2012

Primero enviado que cumplió con los criterios de control de calidad

28 de marzo de 2012

Publicado por primera vez (Estimar)

30 de marzo de 2012

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

23 de febrero de 2017

Última actualización enviada que cumplió con los criterios de control de calidad

5 de enero de 2017

Última verificación

1 de enero de 2017

Más información

Términos relacionados con este estudio

Palabras clave

Términos MeSH relevantes adicionales

Otros números de identificación del estudio

  • 41552-G

Plan de datos de participantes individuales (IPD)

¿Planea compartir datos de participantes individuales (IPD)?

NO

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. .

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