Improving Outcomes for Emergency Department Patients With Alcohol Problems
| Status: | Not yet recruiting |
|---|---|
| Conditions: | Hospital, Psychiatric |
| Therapuetic Areas: | Psychiatry / Psychology, Other |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 3/17/2019 |
| Start Date: | May 1, 2019 |
| End Date: | May 31, 2022 |
| Contact: | Deborah A Manderachia, MSW |
| Email: | deborah.manderachia@va.gov |
| Phone: | (734) 222-7424 |
The investigators will conduct a study to examine the impact of an alcohol peer-mentor
intervention starting in the emergency department (ED) combined with 6 peer booster sessions
to reduce hazardous drinking and facilitate primary/specialty care use compared to enhanced
usual care. Approximately 450 Veterans with hazardous drinking behaviors will be randomized
to one of these two conditions. Follow-up assessments will occur at 3-, 6-, and 12-month
post-randomization.
intervention starting in the emergency department (ED) combined with 6 peer booster sessions
to reduce hazardous drinking and facilitate primary/specialty care use compared to enhanced
usual care. Approximately 450 Veterans with hazardous drinking behaviors will be randomized
to one of these two conditions. Follow-up assessments will occur at 3-, 6-, and 12-month
post-randomization.
The objective of the study is to conduct a randomized controlled trial to determine the
efficacy of an alcohol peer-mentor intervention starting in the ED, combined with a
continuing 6-session program of post-ED strengths-based peer mentorship to facilitate
reduction in hazardous drinking, and linkage and engagement in primary and/or specialty
alcohol treatment services and mental health care, if needed. Project Methods: The study will
screen Veterans Affairs (VA) ED patients for hazardous drinking. Those screening positive and
who enroll in the study will be randomized to one of two conditions: 1) Alcohol Peer-Mentor
(APM) intervention (n=225), or 2) Brief Advice (BA) comparison condition (n=225). Stratified
random assignment to conditions will be by sex and presence of AUD (yes/no) defined as a
score of 14 for men and 10 for women on the AUDIT. Randomization will proceed in blocks of
10. All participants will also receive written community resource information. Participants
randomized to the APM condition will receive peer support to reduce hazardous drinking, and
those who meet alcohol use disorder criteria will be coached by the peer and will assist in a
warm handoff linkage to addiction treatment.
efficacy of an alcohol peer-mentor intervention starting in the ED, combined with a
continuing 6-session program of post-ED strengths-based peer mentorship to facilitate
reduction in hazardous drinking, and linkage and engagement in primary and/or specialty
alcohol treatment services and mental health care, if needed. Project Methods: The study will
screen Veterans Affairs (VA) ED patients for hazardous drinking. Those screening positive and
who enroll in the study will be randomized to one of two conditions: 1) Alcohol Peer-Mentor
(APM) intervention (n=225), or 2) Brief Advice (BA) comparison condition (n=225). Stratified
random assignment to conditions will be by sex and presence of AUD (yes/no) defined as a
score of 14 for men and 10 for women on the AUDIT. Randomization will proceed in blocks of
10. All participants will also receive written community resource information. Participants
randomized to the APM condition will receive peer support to reduce hazardous drinking, and
those who meet alcohol use disorder criteria will be coached by the peer and will assist in a
warm handoff linkage to addiction treatment.
Inclusion Criteria:
Screening:
- Presenting for care in the Ann Arbor Veterans Health Administration (VHA) ED
- Medically stable
- Able to provide informed consent
Enrollment:
- Have an AUDIT-C score of 4 or more for men and 3 or more for women in the prior 3
months, indicating that they meet criteria for hazardous use (NIAAA 2005; World Health
Organization)
- Have a telephone and/or the ability to provide information about individuals who can
help contact the participant
Exclusion Criteria:
Screening:
- Do not understand English
- Patients in or having received substance abuse treatment in the past 3-months, per
medical record
- Patients in or having received peer services in the past 3-months, per medical record
- Pregnant women
- Patients deemed unable to provide informed consent
- Profound psychotic symptoms and/or cognitive deficits that would prevent patients from
understanding the content of the intervention and/or assessments
Enrollment:
- Patients currently active in or having received alcohol or other substance abuse
treatment in the past 3-months, per self-report screening.
- Patients currently active in or having received peer services in the past 3-months,
per self-report screening.
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