This component of a larger Center of Research Excellence Grant improves treatment for drug abuse by developing effective linkages between specialty drug treatment and primary health care.
This is a longitudinal two-arm quasi-experimental 3-month alternating off/on design over a 30 month period in which, after a random start, the Linkage condition alternately is added to Usual Care in the Chemical Dependency (CD) clinic and then removed. We compare Usual Care to Usual Care plus Linkage. Follow-up interviews will be conducted at 6, 12 and 24 months. The Linkage intervention includes Usual Care plus 1) sessions on activation regarding overall health behaviors and on selecting a Primary Care physician and communicating with him/her, and 2) a linkage phone call (and/or a facilitated email) with the patient, clinician, and Primary Care physician. The intervention aims to place drug abuse problems in the context of overall health and health care and to activate patients to increase involvement in their own health care.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
504
Usual Care plus Linkage encompassed Usual Care with the exception that the six 45-min Linkage patient activation education groups replaced the six 45-min Usual Care medical education groups, plus a linkage phone call (and/or a facilitated email) with the patient, clinician, and Primary Care physician. The patient activation intervention components -- 1) six 45-min Linkage sessions on activation regarding overall health behaviors and 2) a linkage phone call (and/or a facilitated email) with the patient, clinician, and PC physician -- were delivered by a clinical psychologist.
Kaiser Permanente, Chemical Dependency Recovery Program
San Francisco, California, United States
patient activation measure
Measured by Patient Activation Measure (PAM) from interview data
Time frame: 6 months post baseline
patient engagement in health care (including patient portal use, familiarity and satisfaction with Primary Care physician, and CD treatment length of stay)
Measured by data from interviews and Electronic Health Record (EHR)
Time frame: 6 months post baseline
Substance use and mental health outcomes
Measures include past 30-day alcohol, drug and total abstinence; Patient Health Questionnaire (PHQ-9) and Addiction Severity Index using interview data
Time frame: 6 months post baseline
patient activation measure at 12 and 24 months
Measured by Patient Activation Measure (PAM) from interview data
Time frame: 12 and 24 months post baseline
patient engagement in health care at 12 and 24 months
Measured by data from interviews and Electronic Health Record (EHR)
Time frame: 12 and 24 months post baseline
Substance use and mental health outcomes at 12 and 24 months
Measures include past 30-day alcohol, drug and total abstinence; Patient Health Questionnaire (PHQ-9) and Addiction Severity Index using interview data
Time frame: 12 and 24 months post baseline
Health care utilization and cost
Measured by data from interviews and adminstrative data
Time frame: 12 and 24 months post baseline
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