Motivoiva haastattelu masennuspotilaiden päihteiden käytön vähentämiseksi
maanantai 8. kesäkuuta 2015 päivittänyt: University of California, San Francisco
Tutkimuksen tavoitteena on arvioida 300 masennukseen hoitoon hakeutuvan aikuisen otoksessa alkoholin ja huumeiden käytön sekä masennuksen oireiden vähentämiseen, toimintakykyyn parantamiseen ja terveydenhuoltopalvelujen asianmukaista käyttöä edistävän toimenpiteen tehokkuutta. .
Tutkimuksen yleiskatsaus
Tila
Valmis
Interventio / Hoito
Yksityiskohtainen kuvaus
Tämä tutkimus käsittelee tärkeitä kysymyksiä siitä, kuinka tunnistaa ja hoitaa psykiatrian potilaita, jotka hakeutuvat palveluun alkoholin tai huumeiden käytön vuoksi, jotka voivat pahentaa masennusta.
Tutkijat ehdottavat Brief Motivational Intervention (BMI) -tutkimusta vähentämään huumeiden ja alkoholin käyttöä masennuspotilaiden keskuudessa ja tehostamaan sitoutumista Kaiser Chemical Dependency Recovery Program (CDRP) -ohjelmaan tarvittaessa.
Masennuksesta kärsivillä potilailla, jotka käyttävät huumeita tai alkoholia jopa alidiagnostisella tasolla, on suuri riski päihdeongelmien eskaloitumiselle.
BMI on innovatiivinen, näyttöön perustuva lähestymistapa, joka voi vähentää huumeiden ja alkoholin käyttöä ja parantaa tuloksia.
Mutta sitä ei ole testattu masennuspotilaiden keskuudessa.
Tämä tutkimusotoote sisältää 300 avohoitopotilasta masennuksen hoidossa Kaiser Permanente Northern California Hayward/Fremont Psychiatryssa.
Osallistumiskriteerit perustuvat huumeiden käyttöön (kaikki laittomat huumeiden käyttö ja reseptilääkkeiden käyttö ilman reseptiä) ja vaaralliseen juomiseen (eli ≥ 3 annosta päivässä naisilla ja ≥ 4 annosta päivässä miehillä) sekä keskivaikeaan tai vakavaan masennusoireita ottamisen yhteydessä.
Kolmesataa potilasta satunnaistetaan saamaan yksi henkilökohtainen BMI-istunto ja kaksi puhelimitse BMI-istuntoa kuuden viikon kuluessa ottamisesta (interventio) tai esite huumeiden ja alkoholin käytön riskeistä (kontrolli).
Tutkijat odottavat, että interventio vähentää tehokkaasti huumeiden käyttöä ja vaarallista juomista 3, 6 ja 12 kuukauden puhelinseurantahaastatteluissa; parantaa mielialaa ja toiminnallisia tuloksia; masennuksen hoitoon sitoutumisen lisääminen (psykiatrian käyntien määrä, terveydenhuollon tehokkuuden tieto- ja tietojoukon (HEDIS) standardien perusteella); ja helpottaa potilaiden kemiallisen riippuvuuden ohjelmahoidon aloittamista tarvittaessa, ja se on kustannustehokasta.
Potilashoidon parantamiseksi se antaa myös tärkeää tietoa alkoholi- ja huumeinterventioiden integroimisesta psykiatriaan ja siitä, miten parhaiten auttaa potilaita pääsemään tarvittaessa CDRP-erikoispalveluihin.
Opintotyyppi
Interventio
Ilmoittautuminen (Todellinen)
307
Vaihe
- Ei sovellettavissa
Yhteystiedot ja paikat
Tässä osiossa on tutkimuksen suorittajien yhteystiedot ja tiedot siitä, missä tämä tutkimus suoritetaan.
Opiskelupaikat
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California
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Union City, California, Yhdysvallat, 94545
- Kaiser Permanente Medical Center Southern Alameda County
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Osallistumiskriteerit
Tutkijat etsivät ihmisiä, jotka sopivat tiettyyn kuvaukseen, jota kutsutaan kelpoisuuskriteereiksi. Joitakin esimerkkejä näistä kriteereistä ovat henkilön yleinen terveydentila tai aiemmat hoidot.
Kelpoisuusvaatimukset
Opintokelpoiset iät
18 vuotta ja vanhemmat (Aikuinen, Vanhempi Aikuinen)
Hyväksyy terveitä vapaaehtoisia
Ei
Sukupuolet, jotka voivat opiskella
Kaikki
Kuvaus
Sisällyttämiskriteerit:
- Vaarallinen juominen (eli ≥ 3 annosta päivässä naisilla ja ≥ 4 annosta päivässä miehillä)
- Huumeiden käyttö (mukaan lukien kaikki laittomat huumeiden käyttö ja reseptilääkkeiden käyttö viimeisten 30 päivän aikana)
- Keskivaikeat tai voimakkaammat masennuksen oireet, jotka perustuvat Potilaan terveyskyselyn (PHQ-9) arvosanaan ≥ 5
Poissulkemiskriteerit:
- Nykyinen mania tai psykoosi
Opintosuunnitelma
Tässä osiossa on tietoja tutkimussuunnitelmasta, mukaan lukien kuinka tutkimus on suunniteltu ja mitä tutkimuksella mitataan.
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
- Ensisijainen käyttötarkoitus: Terveyspalvelututkimus
- Jako: Satunnaistettu
- Inventiomalli: Rinnakkaistehtävä
- Naamiointi: Ei mitään (avoin tarra)
Aseet ja interventiot
Osallistujaryhmä / Arm |
Interventio / Hoito |
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Kokeellinen: Motivoiva haastattelu
Motivaatiohaastattelun (MI) interventio koostui yhdestä 45 minuutin henkilökohtaisesta MI-istunnosta, jota seurasi kaksi 15 minuutin puhelin "tehoste"-istuntoa
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Active Comparator: Ohjaus
Osallistujat saivat esitteen alkoholin ja huumeiden käytön riskeistä.
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Osallistujat saivat esitteen alkoholin ja huumeiden käytön riskeistä.
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Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
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Vaarallinen juominen viimeisten 30 päivän aikana (itse ilmoittama vaarallisten juomien päivien lukumäärä)
Aikaikkuna: 6 kuukautta
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Itse ilmoittama vaarallisten juomien päivien lukumäärä (3+ juomaa päivässä naisilla / 4+ juomaa päivässä miehillä) edellisten 30 päivän aikana.
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6 kuukautta
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Huumeiden käyttö viimeisten 30 päivän aikana (itse ilmoittama huumeiden käyttöpäivien lukumäärä)
Aikaikkuna: 6 kuukautta
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Itse ilmoittama huumeiden käyttöpäivien lukumäärä (laittomien huumeiden käyttö tai reseptilääkkeiden väärinkäyttö) 30 edellisen päivän aikana.
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6 kuukautta
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Vaarallinen juominen viimeisten 30 päivän aikana (itse ilmoittama vaarallisten juomien päivien lukumäärä)
Aikaikkuna: 12 kuukautta
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Itse ilmoittama vaarallisten juomien päivien lukumäärä (3+ juomaa päivässä naisilla / 4+ juomaa päivässä miehillä) edellisten 30 päivän aikana.
Tutkimme muutosta 6 kuukauden käytön ja 12 kuukauden käytön välillä mitataksemme pitkän aikavälin interventiovaikutusta.
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12 kuukautta
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Huumeiden käyttö viimeisten 30 päivän aikana (itse ilmoittama huumeiden käyttöpäivien lukumäärä)
Aikaikkuna: 12 kuukautta
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Itse ilmoittama huumeiden käyttöpäivien lukumäärä (laittomien huumeiden käyttö tai reseptilääkkeiden väärinkäyttö) 30 edellisen päivän aikana.
Tutkimme käytön muutosta 6 kuukauden ja 12 kuukauden välillä mitataksemme pitkän aikavälin interventiovaikutuksia.
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12 kuukautta
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Toissijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
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Masennusoireet (potilaan terveyskyselyn (PHQ-9) pisteet)
Aikaikkuna: 12 kuukautta
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mitataan seurantapuhelinhaastatteluissa. PHQ-9 arvioi 9 tyyppisen ongelman esiintymistiheyden viimeisen 2 viikon aikana; vastaukset vaihtelevat 0:sta (ei ollenkaan) 3:een (melkein joka päivä).
Jos vähintään 4 yhdeksästä on >0, kohdepisteiden summaa käytetään osoittamaan masennuksen vakavuus: 1-4 Minimi; 5-9 Lievä; 10-14 Keskitasoinen; 15-19 Keskivaikea; 20-27 Vakava.
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12 kuukautta
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Riittävä mielenterveyshoito (12 viikkoa jatkuvaa hoitoa Kaiser Permanenten avopsykiatrian osastolla saaneiden osallistujien määrä)
Aikaikkuna: 3 kuukautta
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Kaiser Permanenten avohoitopsykiatrian osastolla 12 viikon jatkuvaa hoitoa saaneiden osallistujien määrä
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3 kuukautta
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Yhteistyökumppanit ja tutkijat
Täältä löydät tähän tutkimukseen osallistuvat ihmiset ja organisaatiot.
Yhteistyökumppanit
Tutkijat
- Päätutkija: Derek D Satre, PhD, University of California, San Francisco
Julkaisuja ja hyödyllisiä linkkejä
Tutkimusta koskevien tietojen syöttämisestä vastaava henkilö toimittaa nämä julkaisut vapaaehtoisesti. Nämä voivat koskea mitä tahansa tutkimukseen liittyvää.
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