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

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ClinicalTrials.gov Identifier: NCT00993395
Recruitment Status : Unknown
Verified October 2009 by Johns Hopkins University.
Recruitment status was:  Not yet recruiting
First Posted : October 12, 2009
Last Update Posted : October 12, 2009
Sponsor:
Collaborator:
Healthways, Inc.
Information provided by:
Johns Hopkins University

Brief Summary:
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 or disease Intervention/treatment Phase
Substance Addiction Behavioral: peer mentor-based disease management Not Applicable

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 160 participants
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Supportive Care
Official Title: A Comprehensive Peer Mentor-based Disease Management Program for Medically Complex Substance Users
Study Start Date : January 2010
Estimated Primary Completion Date : December 2013
Estimated Study Completion Date : December 2013

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Drug Abuse

Arm Intervention/treatment
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




Primary Outcome Measures :
  1. adherence to first prescription refill after discharge [ Time Frame: 60 days ]

Secondary Outcome Measures :
  1. Adherence to first medical appointment [ Time Frame: 60 days ]
  2. Rate of readmission and emergency department visits [ Time Frame: 3 years ]
  3. Length of stay in a recovery program [ Time Frame: 1 year ]
  4. Number of days without substance use [ Time Frame: 3 years ]
  5. Acquisition of medical insurance [ Time Frame: 1 year ]
  6. acquisition of long-term housing [ Time Frame: 3 years ]
  7. Acquisition of financial support [ Time Frame: 3 years ]


Information from the National Library of Medicine

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Ages Eligible for Study:   Child, Adult, Older Adult
Sexes Eligible for Study:   All
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

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): 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.

Responsible Party: Jeffery Hunter Young, Assistant Professor, Johns Hopkins University
ClinicalTrials.gov Identifier: NCT00993395     History of Changes
Other Study ID Numbers: NA_00020931
First Posted: October 12, 2009    Key Record Dates
Last Update Posted: October 12, 2009
Last Verified: October 2009

Keywords provided by Johns Hopkins University:
addiction
peer mentor
adherence

Additional relevant MeSH terms:
Behavior, Addictive
Substance-Related Disorders
Compulsive Behavior
Impulsive Behavior
Chemically-Induced Disorders
Mental Disorders