Improving Retention across the OUD Service Cascade upon Re-entry from Jail using Recovery Management Checkups

使用恢复管理检查提高从监狱重新进入时整个 OUD 服务级联的保留

• 批准号: 9978008
• 负责人: Christy K Scott
• 金额: $ 189.9万
• 依托单位: CHESTNUT HEALTH SYSTEMS, INC.
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-15 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9978008
• 关键词: Address; Alcohol or Other Drugs use; Caring; Chronic; Collaborations; Communities; Complement; County; Crime; Effectiveness; Eligibility Determination; Enrollment; Evidence based intervention; Female; Frequencies; Future; Goals; Health; Health Care Costs; Health Personnel; Household; Illinois; Imprisonment; Individual; Intercept; Intervention; Interview; Jail; Justice; Link; Modeling; Monitor; Nature; Opioid; Outcome; Overdose; Participant; Pattern; Persons; Population; Public Health; Quality of life; Quality-Adjusted Life Years; Randomized; Randomized Controlled Trials; Recording of previous events; Records; Recovery; Relapse; Reporting; Research; Resources; Safety; Schedule; Services; Symptoms; System; Testing; Time; Treatment outcome; Urine; Variant; addiction; base; checkup examination; community based treatment; cost; cost effective; cost effectiveness; experimental study; follow-up; health care service utilization; high risk; improved; incremental cost-effectiveness; innovation; male; medication-assisted treatment; mortality; offender; opioid epidemic; opioid use; opioid use disorder; recidivism; relapse risk; retention rate; safety outcomes; scale up; treatment comparison; treatment duration; trial comparing

7. Abstract Jails provide an optimal setting for intervening with individuals with opioid use disorders (OUD), given the high volume of offenders with OUD, and their high risk of relapse to opioids following their release to the community. It is imperative that individuals with OUD are linked to community-based medication assisted treatment (MAT) upon their re-entry, as well as receive support for their ongoing treatment retention and recovery. The proposed experiment will test an adapted version of an evidence-based intervention, the Recovery Management Checkups (RMC) model, which provides quarterly check-ups and assistance with treatment retention and re-linkage as indicated at the quarterly check-ups. The RMC-Adapted will adjust the frequency and intensity of check-ups based on the individual’s assessed need for treatment, thereby reducing (or lengthening) the time between check-ups for those with (or without) indicators of treatment need. The proposed experiment will compare treatment linkage and retention rates as well as public health and public safety outcomes of 750 male and female offenders randomly assigned to 1 of 3 groups upon release from jail: a) a re-entry as usual (control), b) the original RMC, and c) a RMC-Adaptive version tailored to the participant’s need for treatment. The study will be conducted in collaboration with 6 county jails in Illinois and the MAT providers that currently provide pre- and post-release MAT to offenders with OUD. Pre-release, participants will be screened for history of OUD and eligibility for MAT. All participants will receive research follow-up interviews quarterly for 2 years, which will also include urine testing and records checks (treatment, mortality, recidivism). The study aims are to evaluate: (1) the direct effects of RMC and/or RMC-Adaptive on the OUD service cascade of care (initiation, engagement, retention, re-linkage, and months of MAT participation); (2) the indirect effects of RMC and/or RMC-Adaptive (via months of MAT participation) on public health outcomes (days of opioid use, OUD symptoms, quality of life and the cost of health-care utilization); (3) the indirect effects of RMC and/or RMC-Adaptive (via months of MAT and public health outcomes) on public safety outcomes (illegal activity, re-arrest, re-incarceration, and cost of crime); and (4) the incremental costs and cost-effectiveness of the control vs. RMC vs. RMC-Adaptive in terms of both public health outcomes (days of opioid use, quality adjusted life years [QALYs], cost-of-health-care utilization) and public safety outcomes (re-incarceration and cost of crime). The study will determine if tailoring the checkups to individual’s need for treatment leads to more efficient targeting of resources to those in need, reduces the intervention burden on those with lower need, and results in an improved overall effectiveness and cost-effectiveness of RMC checkups.

7.摘要 监狱为干预阿片类药物使用障碍（OUD）患者提供了最佳环境， OUD罪犯的数量，以及他们在被释放后重新使用阿片类药物的高风险 社区必须将OUD患者与社区药物援助联系起来 在他们重新进入时接受治疗（MAT），并获得持续治疗保留的支持， 复苏拟议中的实验将测试一种基于证据的干预措施的改编版本， 恢复管理检查（RMC）模式，提供季度检查和协助， 治疗保留和重新联系，如季度检查所示。RMC-Adapted将调整 根据个人对治疗需求的评估，进行检查的频率和强度，从而减少 (or延长）有（或没有）治疗需要指标的人的检查间隔时间。的 拟议的实验将比较治疗联系和保留率以及公共卫生和公共卫生， 750名男性和女性罪犯在出狱后被随机分配到3组中的1组： a）照常再入（对照），B）原始RMC，以及c）针对参与者的 需要治疗。这项研究将与伊利诺伊州的6个县监狱和MAT合作进行。 提供者，目前提供前和后释放MAT与OUD罪犯。预发布，参与者将 筛查OUD病史和MAT资格。所有参与者将接受研究后续采访 每季度进行一次，为期2年，其中还将包括尿检和记录检查（治疗、死亡率、累犯）。 本研究的目的是评估：（1）RMC和/或RMC-Adaptive对OUD服务的直接影响 护理级联（启动，参与，保留，重新连接和MAT参与的月数）;（2）间接 RMC和/或RMC-自适应（通过MAT参与的月数）对公共卫生结果（ 阿片类药物的使用，OUD症状，生活质量和医疗保健利用的成本）;（3）RMC的间接影响 和/或RMC-自适应（通过几个月的MAT和公共卫生结果）对公共安全结果的影响（非法 活动，重新逮捕，重新监禁和犯罪成本）;（4）增加的成本和成本效益 对照组与RMC组与RMC-适应组在公共卫生结果（阿片类药物使用天数、质量 调整后的生命年[Qs]，医疗保健利用成本）和公共安全结果（重新监禁和 犯罪成本）。这项研究将确定，根据个人的治疗需要定制检查是否会导致 更有效地将资源用于有需要的人，减少了那些低收入者的干预负担， 需要，并导致RMC检查的整体有效性和成本效益的提高。