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Computer vs Therapist-Delivered Brief Intervention for Drug Abuse in Primary Care

计算机与治疗师对初级保健中药物滥用提供的简短干预

基本信息

批准号：
7689796
负责人：
DACE S SVIKIS
金额：
$ 45.3万
依托单位：
VIRGINIA COMMONWEALTH UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-09-29 至 2013-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7689796
关键词：
Adult Alcohol abuse Alcohol or Other Drugs use American Attention Behavioral Clinic Clinical Clinical Trials Communities Computers Control Groups Cost Effectiveness Analysis Country Data Drug usage Economics Eligibility Determination Enrollment Evaluation Feedback Female Iceberg Internal Medicine Intervention Investments Legal Life Literature Marijuana Measures Medical Motivation Outcome Outpatients Participant Patient Self-Report Patients Persons Pharmaceutical Preparations Primary Health Care Randomized Recruitment Activity Relative (related person)Reporting Research Research Personnel Resources Risk Sampling Scientist Screening procedure Software Engineering Staging Substance Use Disorder Substance abuse problem System Therapeutic Time Toxicology Training Translating Translations United States National Institutes of Health Upper arm Urine Woman Work alcohol use disorder base behavior change brief intervention clinical practice computerized cost design drug abuse brief intervention economic cost economic outcome follow-up interest male meetings novel strategies patient population primary care setting psychosocial research and development research to practice response screening and brief intervention screening, brief intervention, referral, and treatment software development software systems standard care

项目摘要

The vast majority of persons with substance use disorders go undetected and untreated. Proactive screening, brief intervention, and referral for treatment approaches (SBIRT) have tremendous potential for identifying and influencing undetected substance abuse, but efforts to incorporate them in the community have met with substantial obstacles related to training, time, costs, and acceptance. Two alternatives therefore merit serious consideration. First, computer-delivered approaches have shown clear effects on substance use outcomes, and have tremendous advantages in terms of replicability, accessibility, and cost. Second?and most parsimoniously?assessment itself is increasingly demonstrating the ability to positively impact substance use. Both approaches could obviate many of the above-noted obstacles, but have yet to be directly compared to traditional person-delivered SBIRT. Further, the significant effects of assessment on substance use outcomes means that there has yet to be a clear evaluation of the true effect of brief intervention approaches. The current proposal will therefore randomly assign 680 general medical urban outpatients into screening-only control (SC), assessment only (CA), assessment plus computer-delivered BI (CACI), and assessment plus therapist-delivered BI (CATI) conditions, and compare all groups at 1, 3, and 6 month follow-up on (a) substance use outcomes, as measured by self-report and urine toxicology, and (b) cost, using sophisticated economic analyses. Prior to this trial, thorough development research will use patient and expert panel feedback to modify existing and previously successful motivational software (developed by this group) to target primary care medical patients at risk for heavy/problem substance use. The proposed design would allow direct evaluation of two theoretically distinct approaches that, if similar in efficacy to the therapist-delivered condition, could greatly increase access to SBIRT. This design would also set the stage for the most stringent evaluation to-date of SBIRT?s true efficacy in primary care.

绝大多数物质使用障碍患者未被发现和治疗。积极主动