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。 美国医院的入院率。对这一人群的治疗往往不能解决这一疾病的根本原因。 住院：AUD。与酒精相关的医疗并发症住院的患者往往有高风险 酒精相关的医疗问题复发，高住院率和恢复不良 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恢复的方法来弥补护理中的这一差距， 恢复途径的灵活性，同行建模的机会，以及强大的社会支持。初步研究结果 证明了住院病人与同伴康复教练联系的可行性，并显示出减少 酒精消费，增加参与治疗和恢复支持计划， 急诊科就诊。然而，试点研究的样本量、结果和方法有限。这 一项提案试图克服这些局限性，并通过以下方式在这些初步成果的基础上再接再厉： 瞬时评估，使用新的NIAAA定义测量回收，检查成本效益， 使用额外的客观指标（呼气酒精含量水平）评估酒精摄入量，以及 研究社会支持和自我效能作为有效性的潜在机制。该提案将严格 测试一个名为RC-Link的住院病人同伴康复辅导服务的有效性 因AUD引起的医学并发症住院的患者的结局。该计划包括一个床边 在患者住院期间介绍同伴康复教练，并继续提供康复支持， 六个月RC-Link程序提供标准化的对等恢复服务， 患者的需求，并概括为提供社会情感，工具和信息的社会支持， 每一个病人的遭遇。目标1将确定RC-Link计划对酗酒频率的影响， 与对照组相比，生物心理社会功能和AUD缓解。目标2将研究如何每天 感知社会支持和自我效能的变化影响酒精消费，并决定是否 这种关联在RC链路组和控制组之间不同。目标3将审查以下方面的成本效益： RC-Link计划;医院利用率将作为次要结局进行检查。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项目干预与 对照组在研究期后接受简短的干预并与同伴恢复教练联系。 将在基线时、6个月研究期间每月一次和研究后6个月评估结局。 干预这项研究有可能通过提供更好的理解来促进AUD的康复护理， 如何长期，病人发起的同伴恢复教练影响恢复结果随着时间的推移，在这方面 人口