Promoting alcohol treatment engagement post-hospitalization with brief intervention, medications and CBT4CBT: protocol for a randomized clinical trial in a diverse patient population.
Promoting alcohol treatment engagement post-hospitalization with brief intervention, medications and CBT4CBT: protocol for a randomized clinical trial in a diverse patient population.
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DOI：
10.1186/s13722-023-00407-9
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发表时间：
2023-09-19
影响因子：
3.7
通讯作者：
Kiluk, Brian D.
中科院分区：
文献类型：
--
作者：
Edelman, E. Jennifer;Rojas-Perez, Oscar F.;Nich, Charla;Corvino, Joanne;Frankforter, Tami;Gordon, Derrick;Jordan, Ayana;Paris Jr, Manuel;Weimer, Melissa B.;Yates, Brian T.;Williams, Emily C.;Kiluk, Brian D.
关键词：
酒精使用障碍(AUD)通常导致住院，特别是对受结构性种族主义和其他形式的边缘化影响不成比例的个人。AUD住院患者入院后出院治疗的最佳方法尚不清楚。我们描述了Project Enhance(增强医院发起的酒精治疗以增加参与度)的基本原理、目标和协议，这是一项临床试验，测试使用混合类型1有效性实施方法的日益密集的方法。我们正在从康涅狄格州纽黑文的一家大型城市学术医院随机抽取患有未经治疗的澳元(n = 450)的英语和/或西班牙语患者，以：(1)简短的谈判面谈(带有转介和电话助推器)单独(BNI)，(2)BNI加促进酒精使用障碍药物的启动(BNI + MOUD)，或(3)BNI + Maud + 启动认知行为治疗的计算机培训(CBT4CBT，BNI + Maud + CBT4CBT)。干预措施由健康促进倡导者提供。主要结果是出院后34天内参与澳元治疗。次要结果包括AUD治疗参与度、出院后90天以及自我报告的酒精使用和磷脂酰乙醇的变化。探索性结果包括卫生保健利用情况。我们将探索在种族主义和种族群体之间和内部，关于澳元治疗参与度和酒精使用结果的干预措施的有效性是否存在差异，这与澳元不成比例的影响一致。最后，我们将进行以实施为重点的过程评估，包括对提供者和患者的成本、成本效益指数(效果/成本比率)和成本效益指数(效益/成本比、净效益[效益减去成本])这三种情况进行个人层面的收集和统计比较。个人和群体一级的效率x成本和收益x成本的图表将以社区代表也能够理解和使用的方式描绘三种条件下的成本和效率之间以及成本和收益之间的关系。预计Enhance项目将产生新的发现，为未来医院在不同患者群体中促进AUD治疗参与的努力提供信息，包括那些受AUD影响最大的患者。临床试验注册：ClinicalTrials.gov标识：NCT05338151。网上版载有补充材料，可在10.1186/s13722-023-00407-9查阅。
Alcohol use disorder (AUD) commonly causes hospitalization, particularly for individuals disproportionately impacted by structural racism and other forms of marginalization. The optimal approach for engaging hospitalized patients with AUD in treatment post-hospital discharge is unknown. We describe the rationale, aims, and protocol for Project ENHANCE (ENhancing Hospital-initiated Alcohol TreatmeNt to InCrease Engagement), a clinical trial testing increasingly intensive approaches using a hybrid type 1 effectiveness-implementation approach. We are randomizing English and/or Spanish-speaking individuals with untreated AUD (n = 450) from a large, urban, academic hospital in New Haven, CT to: (1) Brief Negotiation Interview (with referral and telephone booster) alone (BNI), (2) BNI plus facilitated initiation of medications for alcohol use disorder (BNI + MAUD), or (3) BNI + MAUD + initiation of computer-based training for cognitive behavioral therapy (CBT4CBT, BNI + MAUD + CBT4CBT). Interventions are delivered by Health Promotion Advocates. The primary outcome is AUD treatment engagement 34 days post-hospital discharge. Secondary outcomes include AUD treatment engagement 90 days post-discharge and changes in self-reported alcohol use and phosphatidylethanol. Exploratory outcomes include health care utilization. We will explore whether the effectiveness of the interventions on AUD treatment engagement and alcohol use outcomes differ across and within racialized and ethnic groups, consistent with disproportionate impacts of AUD. Lastly, we will conduct an implementation-focused process evaluation, including individual-level collection and statistical comparisons between the three conditions of costs to providers and to patients, cost-effectiveness indices (effectiveness/cost ratios), and cost–benefit indices (benefit/cost ratios, net benefit [benefits minus costs). Graphs of individual- and group-level effectiveness x cost, and benefits x costs, will portray relationships between costs and effectiveness and between costs and benefits for the three conditions, in a manner that community representatives also should be able to understand and use. Project ENHANCE is expected to generate novel findings to inform future hospital-based efforts to promote AUD treatment engagement among diverse patient populations, including those most impacted by AUD. Clinical Trial Registration: Clinicaltrials.gov identifier: NCT05338151. The online version contains supplementary material available at 10.1186/s13722-023-00407-9.
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DOI：
10.1111/acer.13410
发表时间：
2017-07
期刊：
Alcoholism, clinical and experimental research
影响因子：
--
作者：
Busch AC;Denduluri M;Glass J;Hetzel S;Gugnani SP;Gassman M;Krahn D;Deyo B;Brown R
通讯作者：
Brown R
DOI：
10.1111/acer.13471
发表时间：
2017-10
期刊：
Alcoholism, clinical and experimental research
影响因子：
--
作者：
Afshar M;Burnham EL;Joyce C;Clark BJ;Yong M;Gaydos J;Cooper RS;Smith GS;Kovacs EJ;Lowery EM
通讯作者：
Lowery EM
影响因子：
3.5
作者：
Bernstein, Edward;Bernstein, Judith;Owens, Patricia
通讯作者：
Owens, Patricia
影响因子：
6.2
作者：
Bernstein, E;Bernstein, J;Levenson, S
通讯作者：
Levenson, S
影响因子：
6.2
作者：
D'Onofrio, Gail;Fiellin, David A.;O'Connor, Patrick G.
通讯作者：
O'Connor, Patrick G.