Patient Centered Assessment and Substance Use Disorder Treatment Study (PCAST)

RTI International

Status: Completed

Conditions: Substance Use Disorders

Treatments: Other: Non-adherence to ASAM protocols; Other: Adherence to ASAM protocols

Study type: Observational

Funder types: Other

Identifiers

NCT03486028

0216289

Details and patient eligibility

About

California counties are in the process of implementing a Centers for Medicare and Medicaid Services Medicaid 1115 Substance Use Disorder (SUD) demonstration. The demonstration requires that patients be assigned to addiction treatment settings and levels of care systematically, using comprehensive biopsychosocial assessments and guided by the American Society of Addiction Medicine (ASAM) patient placement criteria.

RTI International, a nonprofit research institute, and University of California Los Angeles (UCLA) Integrated Substance Abuse Programs have been awarded a contract from the Patient Centered Outcomes Research Institute (PCORI) to study the effects of the ASAM implementation in California. The California 1115 SUD demonstration provides a unique opportunity to learn about the benefits and challenges resulting from system-wide implementation of ASAM criteria.

The study will involve surveying patients in counties that are using the ASAM criteria and in counties that have not yet adopted the ASAM criteria. Medicaid patients receiving addiction treatment will be offered the opportunity participate in the study and to be surveyed about their experiences in treatment. The study will also analyze data from the California Outcomes Management System (CalOMS) and conduct interviews with providers, patients, and policymakers in the state. The results of the study will help inform California's efforts to continually improve its addiction treatment systems to better meet the needs of it communities. This study will also produce important and useful information to patients seeking treatment for addiction, and their providers, SUD system administrators, and payers.

Enrollment: 991 patients

Sex: All

Ages: 19+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Individuals age 19 or older
• Receiving treatment for addiction in specialty addiction treatment programs licensed in California who are Medicaid beneficiaries.

Exclusion criteria

• Less than 19 years old
• Not receiving treatment for addiction in specialty addiction treatment programs licensed in California
• Not Medicaid beneficiaries

Trial design

991 participants in 3 patient groups

ASAM Counties/non-computerized

Description:

Pre- and 1115-waived counties that are implementing the ASAM. Intervention is adherence to ASAM protocols.

Treatment:

Other: Adherence to ASAM protocols

ASAM Counties/computerized

Description:

Counties using a computerized system to assist in intervention determination according to ASAM protocols. Intervention is adherence to ASAM protocols.

Treatment:

Other: Adherence to ASAM protocols

Non-ASAM Counties

Description:

Pre- and non-waived "control" counties that are not implementing the ASAM. Intervention is non-adherence to ASAM protocols.

Treatment:

Other: Non-adherence to ASAM protocols