Collaborative Care for Alcohol Use Disorders in the Patient-centered Medical Home
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Psychiatric, Psychiatric |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - 75 |
| Updated: | 12/20/2018 |
| Start Date: | January 2017 |
| End Date: | March 2019 |
The purpose of this research study is to develop and test a care model to treat excessive
drinking and alcohol use disorders in the primary care setting. The goal of this research
study is to increase the identification and treatment of problem drinking in the primary care
setting. Individuals will be asked to participate in this study because routine screening and
assessment conducted at your primary care clinic indicates that you have recently exceeded
healthy drinking limits as outlined by the National Institutes of Alcohol and Alcoholism.
drinking and alcohol use disorders in the primary care setting. The goal of this research
study is to increase the identification and treatment of problem drinking in the primary care
setting. Individuals will be asked to participate in this study because routine screening and
assessment conducted at your primary care clinic indicates that you have recently exceeded
healthy drinking limits as outlined by the National Institutes of Alcohol and Alcoholism.
Excessive drinking (ED) and alcohol use disorders (AUD) remain one of the nation's leading
public health problems, yet this problem is largely under-recognized and undertreated.
Although many people with ED/AUD see a primary care physician annually, there has been
limited research and implementation of models to treat ED/AUD in primary care. Important
changes in the healthcare system and advances in alcohol research offer new and potentially
transformative opportunities to integrate ED/AUD treatment into primary care practices. In
particular, these changes have led to the development of new patient-centered, integrated
care models that facilitate the treatment behavioral health issues in primary care. Experts
have repeatedly called for the development of a chronic care model to treat alcohol problems
in primary care, similar to models now used to treat other chronic illnesses, including
depression. Yet, research to develop and test such models has been surprisingly limited. The
primary aim of this study is to develop and test a chronic care model to treat ED/AUD in the
patient-centered model home (PCMH) using the NIH stage model of intervention development.
Specifically, using a mixed methods approach, this study proposes to adapt and test the
collaborative care (CC) model for depression to treat ED/AUD in a high volume PCMH.
Importantly, we will build the CC model onto a Screening, Brief Intervention, and Referral to
Treatment (SBIRT) program that is already in place in the PCMH. Notably, this SBIRT model
currently refers those with ED/AUD out to specialty treatment providers. The proposed study
will be conducted in two phases. Phase I will involve initial adaptation of the CC model for
depression. During this phase, relevant depression CC protocols and measures will be adapted
for ED/AUD and piloted tested on participants (n = 25) recruited in a PCMH. Phase II will
involve model refinement based on iterative cycles of patient and PCMH staff feedback and
examination of drinking outcome data. During this phase, participants (n = 60) will be
assessed and followed for three months. Iterative development will focus on: 1) utilizing a
stepped-care model of treatment which will include outpatient detoxification, behavioral
interventions, and medication intervention and management, 2) maximizing patient engagement,
and 3) balancing the resource and expertise constraints of treating ED/AUD in a PCMH.
Participants in Phases 1 and 2 will be followed at 1 and 3 months and primary outcome data on
drinking outcomes will be examined.
public health problems, yet this problem is largely under-recognized and undertreated.
Although many people with ED/AUD see a primary care physician annually, there has been
limited research and implementation of models to treat ED/AUD in primary care. Important
changes in the healthcare system and advances in alcohol research offer new and potentially
transformative opportunities to integrate ED/AUD treatment into primary care practices. In
particular, these changes have led to the development of new patient-centered, integrated
care models that facilitate the treatment behavioral health issues in primary care. Experts
have repeatedly called for the development of a chronic care model to treat alcohol problems
in primary care, similar to models now used to treat other chronic illnesses, including
depression. Yet, research to develop and test such models has been surprisingly limited. The
primary aim of this study is to develop and test a chronic care model to treat ED/AUD in the
patient-centered model home (PCMH) using the NIH stage model of intervention development.
Specifically, using a mixed methods approach, this study proposes to adapt and test the
collaborative care (CC) model for depression to treat ED/AUD in a high volume PCMH.
Importantly, we will build the CC model onto a Screening, Brief Intervention, and Referral to
Treatment (SBIRT) program that is already in place in the PCMH. Notably, this SBIRT model
currently refers those with ED/AUD out to specialty treatment providers. The proposed study
will be conducted in two phases. Phase I will involve initial adaptation of the CC model for
depression. During this phase, relevant depression CC protocols and measures will be adapted
for ED/AUD and piloted tested on participants (n = 25) recruited in a PCMH. Phase II will
involve model refinement based on iterative cycles of patient and PCMH staff feedback and
examination of drinking outcome data. During this phase, participants (n = 60) will be
assessed and followed for three months. Iterative development will focus on: 1) utilizing a
stepped-care model of treatment which will include outpatient detoxification, behavioral
interventions, and medication intervention and management, 2) maximizing patient engagement,
and 3) balancing the resource and expertise constraints of treating ED/AUD in a PCMH.
Participants in Phases 1 and 2 will be followed at 1 and 3 months and primary outcome data on
drinking outcomes will be examined.
Inclusion Criteria:
- Exceed NIAAA weekly or daily guidelines
- receive care at the 865 clinic
- are fluent in English
- are willing to provide signed, informed consent to participate
- available to complete research follow-ups
- are able to read English at the eighth grade or higher level and show no evidence of
significant cognitive impairment
Exclusion Criteria:
- Meet DSM-V criteria for drug dependence other than for marijuana or nicotine
- on probation or parole
- have a serious psychiatric illness (e.g., psychotic disorder, bipolar disorder, severe
major depression, etc.) that is likely to require pharmacologic treatment or that is
currently treated with psychotropic medication; organic mood or mental disorders, or
substantial suicide or violence risk
We found this trial at
1
site
Great Neck, New York 11021
Principal Investigator: Jon Morgenstern, Ph.D.
Phone: 516-837-1675
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