Project Health Link: Connecting Patients With Services

University of Michigan

Status: Completed

Conditions: Alcohol Abuse

Treatments: Behavioral: Strengths Based Case Management; Behavioral: Brief Informational Feedback; Behavioral: Motivational Enhancement Therapy

Study type: Interventional

Funder types: Other

Identifiers

NCT00234221

1R01AA014665-01A1

Details and patient eligibility

About

This study will compare three alternative interventions in the emergency department (ED) to promote substance abuse assessment, referral, and treatment entry: 1) a 5 session strengths-based case management model (SBCM); 2) a 2-session motivational enhancement therapy (MET); or 3) a one-time brief informational feedback (BIF) session. The primary outcome variables for this trial include follow-through on receiving an assessment and referral, and treatment engagement. Additional outcomes include degree of treatment completion, alcohol-related measures, health service utilization, health status changes, and psychosocial factors.

Enrollment: 686 patients

Sex: All

Ages: 19 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• (1) adults age 19 - 60 presenting to the Emergency Department at Hurley Medical Center within 24 hours of an injury; (2) ability to provide informed consent.

For intervention portion of the project: (1) meets DSM-IV criteria for alcohol abuse or dependence in the following year. (Patients who meet abuse/dependence criteria for alcohol may also be using other drugs. They will be included in the study only if they do not meet criteria for past year drug abuse/dependence).

Exclusion criteria

• (1) adult patients who do not understand English; (2) prisoners; (3) pregnant women; (4) institutionalized patients (e.g. nursing home residents); (5) adults classified by medical staff as "Level 1 trauma"; (6) adults deemed unable to provide informed consent (e.g. intoxication, mental incompetence, under guardianship); (7) patients treated in the ED for suicide attempts and sexual assault; (8) patients meeting past year drug abuse/dependence criteria; and (9) patients who have been in treatment for alcohol or other drug abuse/dependence in the previous year.

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

---

686 participants in 3 patient groups

Strengths Based Case Management Model (SBCM)

Active Comparator group

Description:

The Strengths Based Case Management Model (SBCM) consists of 5 case-management sessions designed to promote linkage and engagement in assessment and treatment services, while assisting with the patient's perceived needs, as well as personal strengths and barriers to linkage and engagement.

Treatment:

Behavioral: Strengths Based Case Management

Motivational Enhancement Therapy (MET)

Active Comparator group

Description:

The MET therapist will conduct 2 motivational enhancement sessions to work through the content of an educational workbook targeting the participant's alcohol use/abuse with the goal of negotiating a 'contract' to: 1) link to services, with the eventual goal of seeking and receiving specialized alcohol treatment; or 2) provide a strategy to self-monitor alcohol use, consider consequences, and later seek assessment.

Treatment:

Behavioral: Motivational Enhancement Therapy

Brief Informational Feedback (BIF) session

Active Comparator group

Description:

Subjects will receive brief informational feedback on the results of their alcohol screening and assessment and encouragement to seek treatment.

Treatment:

Behavioral: Brief Informational Feedback