Assertive Community Treatment for Patients Suffering From Substance Use Disorders

NCT03623178 | Completed

• 1 other identifier: ID 2017-01087
• Study Type: observational
• Target: 29
• 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. Persons with substance use disorder often present a chaotic use of the health system, including a high number of hospitalizations in times of crisis. These individuals 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. Community Interventions, such as Assertive Community Treatment (ACT) should increase the adherence of these patients to treatment by accompanying them in the community and helping them during sensitive and crisis periods. One of the objectives of the study is to evaluate the impact of ACT on the time until service disengagement, measuring treatment adherence. The secondary objectives of this study will be to see the effect of ACT on duration and type of hospitalizations, as well as the number of emergency room visits. The investigators will focus on the impact of ACT 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 study will investigate this through questionnaires at the beginning of care, at three months, six months and 12 months after the start of the ACT intervention.

Conditions

Substance Use Disorders

Keywords

Substance Use Disorders; Assertive Community Treatment; Community Treatment; Treatment engagement; Service Use

Outcome Measures

Primary Outcomes (1)

• Treatment adherence

  Number of days until service disengagement

  at 12 months

Secondary Outcomes (7)

• Service use

  at 12 months

• Patient network

  0, 3, 6, 12 months

• Number of ER visits

  0, 3, 6, 12 months

• Addictive behaviour

  0, 3, 6, 12 months

• General psychiatric symptoms

  0, 3, 6, 12 months

Other Outcomes (1)

• Patient satisfaction with Assertive Community Treatment

  at 3, 6, 12 months

Study Arms (1)

Assertive Community Treatment

patients with DSM-5 Diagnosis of SUD and one of the following criteria (1) present important functional difficulties, in at least one of the following areas: everyday life activities and maintaining a supportive social network, for minimum two years. or (2) difficulties to attend their health care appointments, during the last 3 months.

Other: Assertive Community Treatment

Interventions

Assertive Community Treatment OTHER

The intervention program is a type of very flexible community treatment. This is facilitated by a small case load ratio per health care professional (1:10). The healthcare workers are specialized in SUD treatment. The time of the intervention differs, there is no prefixed limitation but the duration of the intervention depends on the goals agreed on with the patient. The main objective of this intervention is to ensure an adherence to an addiction treatment program and establish or consolidate a stable healthcare and social network for the patient. The intervention aims to prevent service disengagement. The healthcare workers will explore specific patient needs and ensure that health and social services are better coordinated to fit their needs.

Assertive Community Treatment

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 with difficulties in engaging in substance use disorder treatment.

You may qualify if:

• Substance use disorder
• Competent subjects, able to give informed consent
• French speaking

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

MeSH Terms

Conditions

Substance-Related Disorders

Interventions

Community Mental Health Services

Condition Hierarchy (Ancestors)

Chemically-Induced Disorders; Mental Disorders

Intervention Hierarchy (Ancestors)

Mental Health Services; Behavioral Disciplines and Activities; Community Health Services; Health Services; Health Care Facilities Workforce and Services

Study Officials

• Louise Penzenstadler, MD

  University Hospital, Geneva

  PRINCIPAL INVESTIGATOR

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: August 1, 2018
• First Posted: August 9, 2018
• Study Start: December 1, 2017
• Primary Completion: January 1, 2023
• Study Completion: December 1, 2023
• Last Updated: May 21, 2025

Record last verified: 2018-08

Data Sharing

• IPD Sharing: Will not share

Locations

CH (1)