Project Health Link: Connecting Patients With Services

University of Michigan

Status: Completed

Conditions: Drug Abuse

Treatments: Behavioral: Motivational Enhancement Therapy (MET); Behavioral: Strengths Based Case Management (SBCM); Behavioral: Brief Informational Feedback (BIF) session

Study type: Interventional

Funder types: Other

Identifiers

NCT00251173

1R01DA016591-01A1

Details and patient eligibility

About

The proposed study will compare three alternative interventions in the emergency department (ED) to promote linkage to substance abuse assessment, referral and treatment entry for those who meet abuse/dependence criteria for stimulants, cannabis, and/or non-injected opioids: (1) a 5-session Strengths-Based Case Management (SBCM) model; (2) a 2-session Brief Motivational Enhancement (BME); or (3) a one-time Brief Informational Feedback (BIF) session. The primary outcome variables for this trial include receiving an assessment and referral and treatment entry. Other outcomes include degree of treatment completion, substance-related measures, health service utilization, health status changes, and psychosocial factors.

Enrollment: 755 patients

Sex: All

Ages: 19 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

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

Additional inclusion criteria for intervention study: meets criteria for substance abuse or dependence for stimulants (cocaine powder, crack cocaine, methamphetamine, amphetamine), cannabis (marijuana, hashish), and or opioids (noninjected heroin, other opioids such as hydrocodone and oxycodone) in the previous year.

Exclusion criteria

• (1) adult patients who do not understand English; (2) prisoners; (3) adults classified by medical staff as "Level 1 trauma"; (4) adults deemed unable to provide informed consent as stated above (e.g., intoxication, mental incompetence); (5) patients treated in the ED for suicide attempts and sexual assaults; (6) patients who have been in treatment for substance abuse in the past six months; (7) patients who are triaged to psychiatric emergency services; and (8) patients who report injecting heroin or other opiates in the past year.

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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755 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 (SBCM)

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 substance use/abuse with the goal of negotiating a 'contract' to: 1) link to services, with the eventual goal of seeking and receiving specialized substance treatment; or 2) provide a strategy to self-monitor substance use, consider consequences, and later seek assessment.

Treatment:

Behavioral: Motivational Enhancement Therapy (MET)

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 (BIF) session