Results from two randomized clinical trials evaluating the impact of quarterly recovery management checkups with adult chronic substance users
Results from two randomized clinical trials evaluating the impact of quarterly recovery management checkups with adult chronic substance users
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DOI：
10.1111/j.1360-0443.2009.02525.x
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发表时间：
2009-06-01
期刊：
影响因子：
6
通讯作者：
Dennis, Michael L.
中科院分区：
文献类型：
--
作者：
Scott, Christy K.;Dennis, Michael L.
出院后监测和早期再干预已成为管理许多慢性疾病的标准做法。这两个实验测试了对成年慢性物质使用者实施的康复管理检查（RMC）方案的有效性，RMC包括季度监测、动机访谈以提供个性化的反馈和解决对物质使用的矛盾心理;治疗联系，参与和保留协议，以增加接受的治疗量。从连续成瘾治疗入院招募，两个实验的参与者，平均，36和38岁，主要是女性（59%对46%），非裔美国人（85%对80%），并符合去年的依赖性标准两个实验的参与者被随机分配到RMC或对照组，并在2年内每季度进行一次访谈。在两个实验中，RMC参与者的结果都优于控制参与者。在第二个实验中，在减少再入院天数方面，（Cohen's d = 0.41 vs. d = 0.22），社区中使用物质的连续季度（d = -0.32对比-0.19），上个月的滥用/依赖症状（d = -0.23 vs.-0.02），并在2年内增加禁欲天数（d = +0.29 vs. 0. 04）.RMC提供了持续监测和联系，对慢性药物依赖成年人来说是可行的，也是有效的。
Post-discharge monitoring and early reintervention have become standard practice when managing numerous chronic conditions. These two experiments tested the effectiveness of recovery management checkup (RMC) protocols for adult chronic substance users.RMC included quarterly monitoring; motivational interviewing to provide personalized feedback and to resolve ambivalence about substance use; treatment linkage, engagement and retention protocols to increase the amount of treatment received.Recruited from sequential addiction treatment admissions, participants in the two experiments were, on average, 36 and 38 years of age, mainly female (59% versus 46%), African American (85% versus 80%) and met past-year criteria for dependence (87% versus 76%).Participants in both experiments were assigned randomly to the RMC or control condition and interviewed quarterly for 2 years.The Global Appraisal of Individual Needs (GAIN) was the main assessment instrument.RMC participant outcomes were better than control participants in both experiments. Effect sizes were larger in the second experiment in terms of reducing days to readmission (Cohen's d = 0.41 versus d = 0.22), successive quarters in the community using substances (d = -0.32 versus -0.19), past-month symptoms of abuse/dependence (d = -0.23 versus -0.02) and increasing the days of abstinence over 2 years (d = +0.29 versus 0.04).RMC, which provided ongoing monitoring and linkage, is feasible to conduct and is effective for adults with chronic substance dependence.