A Peer Recovery Coaching Intervention for Hospitalized Alcohol Use Disorder Patients

针对住院酒精使用障碍患者的同伴恢复辅导干预

• 批准号: 10803885
• 负责人: Kaileigh Byrne
• 金额: $ 67.12万
• 依托单位: CLEMSON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-20 至 2028-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10803885
• 关键词: 2 arm randomized control trial; Address; Admission activity; Affect; Alcohol consumption; Alcohol-Related Disorders; Alcoholic Gastritis; Alcohols; American; Caring; Certification; Clinical Trials; Control Groups; Cost Analysis; Cost Effectiveness Analysis; Cost Savings; Disease remission; Ecological momentary assessment; Effectiveness; Emergency Situation; Emergency department visit; Emotional; Evidence based practice; Frequencies; Health; Health Resources; Heavy Drinking; Hospitalization; Hospitals; Inpatients; Intervention; Link; Liver diseases; Measures; Mediating; Medical; Methods; Modeling; Morbidity - disease rate; Motivation; National Institute on Alcohol Abuse and Alcoholism; Outcome; Pancreatitis; Participant; Pathway interactions; Patient Admission; Patients; Persons; Pilot Projects; Population; Prevalence; Process; Randomized, Controlled Trials; Recovery; Recovery Support; Recurrence; Rehabilitation therapy; Reporting; Research; Resources; Sample Size; Sampling; Self Efficacy; Services; Social support; Standardization; Substance Use Disorder; Testing; Time; Visit; Work; addiction; alcohol comorbidity; alcohol content; alcohol use disorder; attributable mortality; biopsychosocial; brief intervention; care systems; community setting; comparison control; cost; cost effective; cost effectiveness; dosage; effectiveness testing; evidence base; experience; flexibility; high risk; hospital readmission; hospital utilization; improved; innovation; intervention delivery; intervention program; long term recovery; medical complication; novel; peer; peer recovery; post intervention; preventable death; program costs; programs; psychosocial; readmission rates; recovery services; reduced alcohol use; secondary outcome; skill acquisition; social health determinants; substance user; success; treatment as usual; trial comparing

Alcohol Use Disorder (AUD) is the third leading cause of preventable deaths in U.S. and accounts for over 10% of U.S. hospital admissions. Treatment for this population often fails to address the underlying cause of the hospitalization: the AUD. Patients hospitalized with alcohol-related medical complications tend to have high-risk for recurrence of alcohol-related medical problems, high rates of hospital readmissions, and poor recovery outcomes. Methods that promote long-term recovery care are needed. Inpatient linkage to peer recovery coaching may bridge this gap in care by providing a method of continued care for AUD recovery that offers flexibility in recovery pathways, peer modeling opportunities, and strong social support. Pilot study results demonstrated the feasibility of inpatient linkage to peer recovery coaching and showed evidence of decreased alcohol consumption, increased engagement in treatment and recovery support programs, and decreased emergency department visits. However, pilot study sample size, outcomes, and methods were limited. This proposal seeks to overcome these limitations and build on these preliminary results by: using ecological momentary assessments, measuring recovery using the new NIAAA definition, examining cost-effectiveness, assessing alcohol consumption using an additional objective measure (breath alcohol content levels), and examining social support and self-efficacy as potential mechanisms of effectiveness. This proposal will rigorously test the effectiveness of an inpatient peer recovery coaching service called the RC-Link program on recovery outcomes in patients hospitalized with medical complications from AUD. The program involves a bedside introduction to a peer recovery coach during the patient’s hospitalization plus continued, recovery support for six-months. The RC-Link program provides standardized peer recovery service that is both personalized to the patients’ needs and generalized to provide socioemotional, instrumental, and informational social support during every patient encounter. Aim 1 will determine the effect of the RC-Link program on frequency of heavy drinking, biopsychosocial functioning, and remission from AUD compared to controls. Aim 2 will examine how daily changes in perceived social support and self-efficacy influence alcohol consumption and determine whether such associations differ between the RC-Link and control groups. Aim 3 will examine the cost-effectiveness of the RC-Link program; hospital utilization rates will be examined as secondary outcomes. These aims will be evaluated using a two-arm randomized controlled trial that compares the RC-Link program intervention to a control group that receives a brief intervention and connection to a peer recovery coach after the study period. Outcomes will be assessed at baseline, monthly during the 6-month study period, and 6-months post- intervention. This study has potential to advance recovery care for AUD by providing a better understanding of how long-term, inpatient-initiated peer recovery coaching influences recovery outcomes over time in this population.

酒精使用障碍(AUD)是美国可预防死亡的第三大原因，占10%以上 美国医院入院人数的比例。对这类人群的治疗往往不能解决导致 住院治疗：澳元。因酒精相关的医疗并发症住院的患者往往具有高风险 与酒精有关的医疗问题复发，再次住院率高，康复差 结果。需要促进长期康复护理的方法。住院患者与同伴康复的联系 教练可以通过提供一种持续护理AUD康复的方法来弥补这一差距，该方法提供了 康复路径的灵活性、同伴模范机会和强大的社会支持。试点研究结果 证明了住院患者与同伴康复辅导联系的可行性，并显示出减少的证据 酒精消费，更多地参与治疗和康复支持方案，并减少 急诊科就诊。然而，初步研究的样本大小、结果和方法都是有限的。这 该提案旨在克服这些限制，并通过以下方式在这些初步结果的基础上再接再厉：使用生态 瞬时评估，使用新的NIAAA定义衡量恢复，检查成本效益， 使用另一项客观指标(呼气酒精含量水平)评估酒精消费，以及 考察社会支持和自我效能感作为有效性的潜在机制。这项提议将严格执行 测试住院患者同伴康复指导服务的有效性，该服务称为RC-Link康复计划 因AUD引起的内科并发症住院患者的结局。这项计划包括床边 在患者住院期间介绍同伴康复教练，并为患者提供持续的康复支持 六个月。RC-Link计划提供标准化的同伴恢复服务，该服务既针对 患者的需求，并概括地提供社会情感，工具性和信息性的社会支持 每一次与病人的接触。目标1将确定RC-Link计划对酗酒频率的影响， 与对照组相比，AUD的生物心理社会功能和缓解情况。《目标2》将每天检查 感受到的社会支持和自我效能感的变化影响饮酒并决定 这种关联在RC-Link和控制组之间有所不同。目标3将检查以下项目的成本效益 RC-Link计划；医院利用率将作为次要结果进行审查。这些目标将是 使用一项双臂随机对照试验进行评估，该试验将RC-Link计划干预与 对照组，在研究期结束后接受短暂的干预和与同伴康复教练的联系。 结果将在基线、6个月研究期间的每月和6个月后进行评估。 干预。这项研究有可能通过更好地了解AUD的康复护理 长期的、由住院患者发起的同伴康复指导如何随着时间的推移影响康复结果 人口。