A Comprehensive Peer Mentor-based Disease Management Program for Medically Complex Substance Users

NCT00993395 | Withdrawn

• 1 other identifier: NA_00020931
• Study Type: interventional
• Target: N/A
• Locations: 1 country
• Sites: 1

Brief Summary

Substance-using adults are admitted to hospital for medical complication from their drug and alcohol use at very high rates; yet, their care is often defined by low rates of referral to addiction treatment programs and recidivism. In 1997, we instituted an integrated medical-substance use treatment program at Johns Hopkins, the First Step Day Hospital, designed for intensive post-acute care of previously hospitalized substance using adults. We have shown that patients with dual diagnoses admitted to First Step more often complete their course of medical care and stay in recovery longer than patients not admitted to First Step.(1;2) On discharge from First Step, patients are medically stable and drug-free. Their substance abuse care is transferred to an out-patient substance abuse treatment facility and their medical care is transferred to their primary care provider. Unfortunately, many patients are lost to follow-up during this transition. We believe that a peer mentor-based disease management program (PM) can provide continuity of care that begins in First Step and continues after discharge thereby increasing the proportion of patients who remain in treatment for their addiction and medical conditions. Peer mentors are persons from the target community who have been in recovery for 5 or more years. In cooperation with patients and providers, peer mentors improve the integration of care, quality of care, and access to healthcare services. This pilot study will test the effectiveness of a peer mentor-based disease management program. The specific aims are to compare the impact of the PM intervention verses enhanced usual care on outcomes in three domains (1) medical/psychiatric health status, (2) addiction recovery, and (3) social resource acquisition. If successful, this study will provide evidence supporting a larger randomized controlled trial of the impact of field workers on post-acute care among patients with dual diagnoses.

Conditions

Substance Addiction

Keywords

addiction; peer mentor; adherence

Outcome Measures

Primary Outcomes (1)

• adherence to first prescription refill after discharge

  60 days

Secondary Outcomes (7)

• Adherence to first medical appointment

  60 days

• Rate of readmission and emergency department visits

  3 years

• Length of stay in a recovery program

  1 year

• Number of days without substance use

  3 years

• Acquisition of medical insurance

  1 year

Study Arms (1)

Peer Mentor Intervention

EXPERIMENTAL

peer mentor-based disease management focusing on three domains: medical care, recovery, and social stabilization

Behavioral: peer mentor-based disease management

Interventions

peer mentor-based disease management BEHAVIORAL

peer mentor-based disease management focused on three domains: medical care, recovery, and social stabilization

Peer Mentor Intervention

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• All patients admitted to an intensive day hospital focused on medically complex substanse users are eligible for enrolment

You may not qualify if:

• Inability to provide informed consent

Sponsors & Collaborators

• Johns Hopkins University: lead
• Healthways, Inc.: collaborator

Study Sites (1)

Johns Hopkins Hospital

Baltimore, Maryland, 21287, United States

Location

MeSH Terms

Conditions

Substance-Related Disorders; Behavior, Addictive

Condition Hierarchy (Ancestors)

Chemically-Induced Disorders; Mental Disorders; Compulsive Behavior; Impulsive Behavior; Behavior

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: October 9, 2009
• First Posted: October 12, 2009
• Study Start: January 1, 2010
• Primary Completion: December 1, 2012
• Study Completion: December 1, 2012
• Last Updated: October 10, 2018

Record last verified: 2018-10

Locations

US (1)