Transitional Case Management for Patients Suffering From Substance Use Disorders

NCT03551301 | Completed

• 1 other identifier: ID 2017-00733
• Study Type: observational
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

According to the World Health Organization the population suffering from addiction problems is increasing. This population is characterized by multiple needs at the medico-psychosocial level. However, some of these patients, a particular subgroup that we are going to be interested in the so-called "high need" user group, find it difficult to access and stay in outpatient treatment programs. They often present a chaotic use of the health system, including a high number of hospitalizations in times of crisis. They also show very low utilization of health care services, accompanied by social marginalization. This can be related to relapses and poor social functioning. A high number of relapses occur particularly at the end of hospitalization. Interventions in the field of addiction, such as Transitional Case Management (TCM) should increase the adherence of these patients to treatment by accompanying them in the sensitive period following hospitalization. One of the objectives of the study is to evaluate the impact of TCM on the number, duration and type of hospitalizations, as well as the number of emergency room visits. The investigators will also measure the duration until the possible future hospitalization, after the TCM. The secondary objectives of this study will be to see the effect of TCM on adherence to outpatient treatment. The investigators will focus on the impact of follow-up on the participant's medico-psycho-social network, substance use and other psychological variables. The investigators will also evaluate his or her psychiatric symptoms and global and social functioning. Life satisfaction and satisfaction with the care received will also be measured. The investigators will compare the population treated by the TCM with the other users of the addiction service who are hospitalized. The study will investigate this through questionnaires at the beginning of care, at one month, three months, six months and 12 months after the start of TCM management.

Conditions

Substance Use Disorders

Keywords

Substance Use Disorders; Case Management; Community Treatment; Hospital discharge

Outcome Measures

Primary Outcomes (1)

• Hospital days

  Number of days in hospital

  at 12 months

Secondary Outcomes (12)

• Service use

  at 12 months

• Patient network

  0, 3, 6, 12 months

• Time to first readmission to hospital

  0, 1, 3, 6, 12 months

• Type of admission (planned versus unplanned)

  0, 1, 3, 6, 12 months

• Number of ER visits

  0, 1, 3, 6, 12 months

Other Outcomes (2)

• Patient satisfaction with Transitional Case Management

  at 1 month

• Duration and intensity of Transitional Case Management intervention

  at 1 month

Interventions

Transitional Case Management OTHER

TCM program is a type of very flexible community treatment in terms of frequency and intensity of care. This is facilitated by a small case load ratio per health care professional (1:10). The healthcare workers are specialised in SUD treatment. The intervention begins during hospitalisation and lasts around 4 weeks after discharge from the hospital. The main aim of this intervention is to accompany the patient in the difficult phase of transition between hospital and outpatient care and ensure their adherence to the treatment program. The healthcare workers will explore specific patient needs and ensure that health and social services are better coordinated to fit their needs. Another important aim is to reduce the number of (unplanned) hospitalizations and emergency room visits.

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Subgroup of high need users hospitalized in our addiction unit

You may qualify if:

• Substance use disorder
• Hospitalisation at recruitment
• Substance Use Disorder according to the DSM-5 and one of the following criteria:
• No preexisting outpatient follow-up care or regular follow-up care
• More than three emergency room visits during the last 12 months
• More than three hospitalizations in psychiatric hospital during the last 12 months
• More than 40 hospitalization's days during the last 12 months
• First hospitalization for a SUD

You may not qualify if:

• Evidence of organic brain disease or learning disability based on the chart review.

Sponsors & Collaborators

• University Hospital, Geneva: lead

Study Sites (1)

Service d'addictologie HUG

Geneva, 1202, Switzerland

Location

Related Publications (1)

• Chatton A, Khazaal Y, Penzenstadler L. A 13-item Health of the Nation Outcome Scale (HoNOS-13): validation by item response theory (IRT) in patients with substance use disorder. Addict Sci Clin Pract. 2023 Oct 24;18(1):64. doi: 10.1186/s13722-023-00416-8.

  PMID: 37876018 DERIVED

MeSH Terms

Conditions

Substance-Related Disorders

Condition Hierarchy (Ancestors)

Chemically-Induced Disorders; Mental Disorders

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal investigator

Study Record Dates

• First Submitted: April 24, 2018
• First Posted: June 11, 2018
• Study Start: September 1, 2017
• Primary Completion: December 4, 2019
• Study Completion: April 1, 2020
• Last Updated: March 20, 2024

Record last verified: 2024-03

Data Sharing

• IPD Sharing: Will not share

Locations

CH (1)