A Pragmatic Trial of the Consult for Addiction Treatment and Care in Hospitals (CATCH) Model for Engaging Patients in Opioid Use Disorder Treatment

NYU Langone Health

Status: Completed

Conditions: Opioid Abuse; Opioid Dependence

Treatments: Behavioral: CATCH Interviews

Study type: Observational

Funder types: Other

Identifiers

NCT03611335

18-00096

Details and patient eligibility

About

This pragmatic clinical trial seeks to evaluate the effectiveness of the Consult for Addiction Treatment and Care in Hospitals (CATCH) intervention as a strategy for engaging patients with Opiod Use Disorder (OUD) in addiction treatment.

Full description

The overarching objective of our study is to evaluate the effectiveness of CATCH as a strategy for engaging patients with OUD in MAT. A pragmatic trial at 6 hospitals, conducted in collaboration with the New York City Health and Hospitals system (H+H) and the New York City Department of Health and Mental Hygiene (DOHMH), will study the CATCH intervention in real-world settings and at scale. Guided by the RE-AIM evaluation framework, this hybrid effectiveness-implementation study (Type 1) focuses primarily on effectiveness, but also measures implementation outcomes to inform the intervention's adoption and sustainability. A rigorous stepped-wedge cluster randomized trial design determines the impact of CATCH on opioid treatment outcomes in comparison to usual care for a control period, followed by a 12-month intervention period and a maintenance period, and utilizes existing administrative data to evaluate outcomes. Aim 1 (primary aim) is to evaluate the effectiveness of CATCH in increasing post-discharge initiation and engagement in MAT, defined respectively as receiving outpatient MAT within 14 days of discharge, and having at least 2 additional MAT visits in the first month. Aim 2 is to assess the effectiveness of CATCH for increasing treatment retention, defined as continuous receipt of MAT for 6 months. Aim 3 is to compare the frequency of acute care utilization and overdose deaths, and their associated costs, among patients with OUD who are hospitalized during the CATCH period versus usual care. Aim 4 is to evaluate implementation outcomes at CATCH sites using a mixed methods approach to assess the intervention's Reach (proportion of eligible patients reached); Adoption (utilization by medical staff); and Implementation fidelity (barriers to delivering high-quality MAT).

Enrollment: 90 patients

Sex: All

Ages: 18 to 99 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adult patients (≥18 years);
• Hospitalized for at least 1 night on an inpatient service (not including intensive care);
• Admission or discharge diagnosis (based on ICD-10 codes) of opioid use disorder or opioid poisoning.

Cases are excluded if they received MAT (buprenorphine, methadone maintenance treatment, or naltrexone) in the 30 days prior to admission. Cases included in the intervention condition must have been admitted on a date following implementation of CATCH.

Exclusion criteria

• Lack of fluency in English, unable to provide informed consent.

Trial design

90 participants in 6 patient groups

Site 1 H+H

Description:

Lincoln Medical and Mental Health Center

Treatment:

Behavioral: CATCH Interviews

Site 2 H+H

Description:

Bellevue Hospital

Treatment:

Behavioral: CATCH Interviews

Site 3 H+H

Description:

Metropolitan Hospital

Treatment:

Behavioral: CATCH Interviews

Site 4 H+H

Description:

Elmhurst Hospital Center

Treatment:

Behavioral: CATCH Interviews

Site 5 H+H

Description:

Coney Island Hospital

Treatment:

Behavioral: CATCH Interviews

Site 6 H+H

Description:

Woodhull Medical and Mental Health Center

Treatment:

Behavioral: CATCH Interviews