A Comprehensive Peer Mentor-based Disease Management Program for Medically Complex Substance Users

The recruitment status of this study is unknown because the information has not been verified recently.
Verified October 2009 by Johns Hopkins University.
Recruitment status was  Not yet recruiting
Sponsor:
Collaborator:
Healthways, Inc.
Information provided by:
Johns Hopkins University
ClinicalTrials.gov Identifier:
NCT00993395
First received: October 9, 2009
Last updated: NA
Last verified: October 2009
History: No changes posted
  Purpose

Substance-using adults are admitted to hospital for medical complication from their drug and alcohol use at very high rates; yet, their care is often defined by low rates of referral to addiction treatment programs and recidivism. In 1997, we instituted an integrated medical-substance use treatment program at Johns Hopkins, the First Step Day Hospital, designed for intensive post-acute care of previously hospitalized substance using adults. We have shown that patients with dual diagnoses admitted to First Step more often complete their course of medical care and stay in recovery longer than patients not admitted to First Step.(1;2) On discharge from First Step, patients are medically stable and drug-free. Their substance abuse care is transferred to an out-patient substance abuse treatment facility and their medical care is transferred to their primary care provider. Unfortunately, many patients are lost to follow-up during this transition. We believe that a peer mentor-based disease management program (PM) can provide continuity of care that begins in First Step and continues after discharge thereby increasing the proportion of patients who remain in treatment for their addiction and medical conditions. Peer mentors are persons from the target community who have been in recovery for 5 or more years. In cooperation with patients and providers, peer mentors improve the integration of care, quality of care, and access to healthcare services. This pilot study will test the effectiveness of a peer mentor-based disease management program. The specific aims are to compare the impact of the PM intervention verses enhanced usual care on outcomes in three domains (1) medical/psychiatric health status, (2) addiction recovery, and (3) social resource acquisition. If successful, this study will provide evidence supporting a larger randomized controlled trial of the impact of field workers on post-acute care among patients with dual diagnoses.


Condition Intervention
Substance Addiction
Behavioral: peer mentor-based disease management

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Supportive Care
Official Title: A Comprehensive Peer Mentor-based Disease Management Program for Medically Complex Substance Users

Further study details as provided by Johns Hopkins University:

Primary Outcome Measures:
  • adherence to first prescription refill after discharge [ Time Frame: 60 days ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Adherence to first medical appointment [ Time Frame: 60 days ] [ Designated as safety issue: No ]
  • Rate of readmission and emergency department visits [ Time Frame: 3 years ] [ Designated as safety issue: No ]
  • Length of stay in a recovery program [ Time Frame: 1 year ] [ Designated as safety issue: No ]
  • Number of days without substance use [ Time Frame: 3 years ] [ Designated as safety issue: No ]
  • Acquisition of medical insurance [ Time Frame: 1 year ] [ Designated as safety issue: No ]
  • acquisition of long-term housing [ Time Frame: 3 years ] [ Designated as safety issue: No ]
  • Acquisition of financial support [ Time Frame: 3 years ] [ Designated as safety issue: No ]

Estimated Enrollment: 160
Study Start Date: January 2010
Estimated Study Completion Date: December 2013
Estimated Primary Completion Date: December 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Peer Mentor Intervention
peer mentor-based disease management focusing on three domains: medical care, recovery, and social stabilization
Behavioral: peer mentor-based disease management
peer mentor-based disease management focused on three domains: medical care, recovery, and social stabilization

  Eligibility

Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • All patients admitted to an intensive day hospital focused on medically complex substanse users are eligible for enrolment

Exclusion Criteria:

  • Inability to provide informed consent
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00993395

Contacts
Contact: Noreen Krause, BS 4109553753 nkrause1@jhmi.edu

Locations
United States, Maryland
Johns Hopkins Hospital Not yet recruiting
Baltmore, Maryland, United States, 21287
Contact: J H Young, MD, MHS    410-502-5808    jhyoung@jhmi.edu   
Sub-Investigator: Anika H. Alvanzo, MD, MS         
Sponsors and Collaborators
Johns Hopkins University
Healthways, Inc.
  More Information

No publications provided

Responsible Party: Jeffery Hunter Young, Assistant Professor, Johns Hopkins University
ClinicalTrials.gov Identifier: NCT00993395     History of Changes
Other Study ID Numbers: NA_00020931
Study First Received: October 9, 2009
Last Updated: October 9, 2009
Health Authority: United States: Institutional Review Board

Keywords provided by Johns Hopkins University:
addiction
peer mentor
adherence

ClinicalTrials.gov processed this record on September 18, 2014