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The Functional-Cognitive and Sensory Treatment (F-CaST) to improve rehabilitation outcomes of individuals with substance use disorder: a study protocol for a mixed-method randomized controlled trial 功能认知和感官治疗(F-CaST)改善药物使用障碍患者的康复效果:混合方法随机对照试验的研究方案
IF 3.7 2区 医学
Addiction Science & Clinical Practice Pub Date : 2024-04-09 DOI: 10.1186/s13722-024-00449-7
Naama Assayag, Tami Bar-Shalita, Debbie Rand
{"title":"The Functional-Cognitive and Sensory Treatment (F-CaST) to improve rehabilitation outcomes of individuals with substance use disorder: a study protocol for a mixed-method randomized controlled trial","authors":"Naama Assayag, Tami Bar-Shalita, Debbie Rand","doi":"10.1186/s13722-024-00449-7","DOIUrl":"https://doi.org/10.1186/s13722-024-00449-7","url":null,"abstract":"Substance use disorder (SUD) is associated with executive function (EF) deficits and sensory modulation dysfunction (SMD). Yet, these deficits are not addressed therapeutically. This study aims to examine the effectiveness of the Functional-Cognitive and Sensory Treatment (F-CaST) compared to standard care to improve everyday performance and behavior and length of stay at the therapeutic community (TC) in individuals with SUD. In addition, to assess the improvement in EF, sensory modulation, participation, self-efficacy, life satisfaction, and use of strategies within and between groups. Satisfaction with F-CaST will also be assessed. Forty-eight participants from a community of men in a TC, aged 18–45 years will be randomly allocated to (i) F-CaST—(experimental group) providing sensory and EF strategies for improving daily function; (ii) standard care (control group) as provided in the TC. Assessments will be conducted by assessors blind to group allocation at 4 time points: T1- pre-intervention; T2- post-intervention; T3- 1-month follow-up; and T4- 3-month follow-up. Primary outcome measures will be everyday performance, assessed by the Canadian Occupational Performance Measure (COPM), behavior and length of stay in the TC; secondary outcome measures will assess EF, SMD. Semi-structured in-depth qualitative interviews will be conducted at T1, T2 and T4. We hypothesize that F-CaST will lead to improved everyday performance and longer length of stay in the TC, compared to the control group. If F-CaST will prove to be effective, cognitive and sensory strategies may be incorporated as an adjunctive intervention in SUD rehabilitation. Trial registration: ClinicalTrials.gov NCT05647863 Registered on 13 December 2022, https://classic.clinicaltrials.gov/ct2/show/NCT05647863 .","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"270 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140579232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Patient and pharmacist perspectives on opioid misuse screening and brief interventions in community pharmacies 患者和药剂师对社区药房阿片类药物滥用筛查和简短干预的看法
IF 3.7 2区 医学
Addiction Science & Clinical Practice Pub Date : 2024-04-08 DOI: 10.1186/s13722-024-00460-y
Deepika Rao, James H. Ford, Olayinka O. Shiyanbola
{"title":"Patient and pharmacist perspectives on opioid misuse screening and brief interventions in community pharmacies","authors":"Deepika Rao, James H. Ford, Olayinka O. Shiyanbola","doi":"10.1186/s13722-024-00460-y","DOIUrl":"https://doi.org/10.1186/s13722-024-00460-y","url":null,"abstract":"Pharmacy-based screening and brief interventions (SBI) offer opportunities to identify opioid misuse and opioid safety risks and provide brief interventions that do not overly burden pharmacists. Currently, such interventions are being developed without patient input and in-depth contextual data and insufficient translation into practice. The purpose of this study is to qualitatively explore and compare patient and pharmacist perceptions and needs regarding a pharmacy-based opioid misuse SBI and to identify relevant SBI features and future implementation strategies. Using the Consolidated Framework for Implementation Research, we conducted semi-structured interviews with 8 patients and 11 pharmacists, to explore needs and barriers to participating in a pharmacy-based SBI. We recruited a purposive sample of English-speaking patients prescribed opioids for chronic or acute pain and pharmacists practicing in varied pharmacies (small independent, large-chain, specialty retail) settings. We used an inductive content analysis approach to analyze patient interview data. Then through a template analysis approach involving comparison of pharmacist and patient themes, we developed strategies for SBI implementation. Most patient participants were white, older, described living in suburban areas, and were long-term opioid users. We identified template themes related to individual, interpersonal, intervention, and implementation factors and inferred applications for SBI design or potential SBI implementation strategies. We found that patients needed education on opioid safety and general opioid use, regardless of opioid use behaviors. Pharmacists described needing patient-centered training, protocols, and scripts to provide SBI. A short-self-reported screening and brief interventions including counseling, naloxone, and involving prescribers were discussed by both groups. Through this implementation-focused qualitative study, we identified patient needs such as opioid safety education delivered in a private and convenient format and pharmacist needs including training, workflow integration, protocols, and a time-efficient intervention for effective pharmacy-based SBI. Alternate formats of SBI using digital health technologies may be needed for effective implementation. Our findings can be used to develop patient-centered pharmacy-based SBI that can be implemented within actual pharmacy practice.","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"17 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140579043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Characterization of peer support services for substance use disorders in 11 US emergency departments in 2020: findings from a NIDA clinical trials network site selection process 2020 年美国 11 个急诊科药物使用障碍同伴支持服务的特点:NIDA 临床试验网络选址过程中的发现
IF 3.7 2区 医学
Addiction Science & Clinical Practice Pub Date : 2024-04-08 DOI: 10.1186/s13722-024-00453-x
Lindsey K Jennings, Laura Lander, Tricia Lawdahl, Erin A. McClure, Angela Moreland, Jenna L. McCauley, Louise Haynes, Timothy Matheson, Richard Jones, Thomas E. Robey, Sarah Kawasaki, Phillip Moschella, Amer Raheemullah, Suzette Miller, Gina Gregovich, Deborah Waltman, Kathleen T. Brady, Kelly S. Barth
{"title":"Characterization of peer support services for substance use disorders in 11 US emergency departments in 2020: findings from a NIDA clinical trials network site selection process","authors":"Lindsey K Jennings, Laura Lander, Tricia Lawdahl, Erin A. McClure, Angela Moreland, Jenna L. McCauley, Louise Haynes, Timothy Matheson, Richard Jones, Thomas E. Robey, Sarah Kawasaki, Phillip Moschella, Amer Raheemullah, Suzette Miller, Gina Gregovich, Deborah Waltman, Kathleen T. Brady, Kelly S. Barth","doi":"10.1186/s13722-024-00453-x","DOIUrl":"https://doi.org/10.1186/s13722-024-00453-x","url":null,"abstract":"Emergency departments (ED) are incorporating Peer Support Specialists (PSSs) to help with patient care for substance use disorders (SUDs). Despite rapid growth in this area, little is published regarding workflow, expectations of the peer role, and core components of the PSS intervention. This study describes these elements in a national sample of ED-based peer support intervention programs. A survey was conducted to assess PSS site characteristics as part of site selection process for a National Institute on Drug Abuse (NIDA) Clinical Trials Network (CTN) evaluating PSS effectiveness, Surveys were distributed to clinical sites affiliated with the 16 CTN nodes. Surveys were completed by a representative(s) of the site and collected data on the PSS role in the ED including details regarding funding and certification, services rendered, role in medications for opioid use disorder (MOUD) and naloxone distribution, and factors impacting implementation and maintenance of ED PSS programs. Quantitative data was summarized with descriptive statistics. Free-text fields were analyzed using qualitative content analysis. A total of 11 surveys were completed, collected from 9 different states. ED PSS funding was from grants (55%), hospital funds (46%), peer recovery organizations (27%) or other (18%). Funding was anticipated to continue for a mean of 16 months (range 12 to 36 months). The majority of programs provided “general recovery support (81%) Screening, Brief Intervention, and Referral to Treatment (SBIRT) services (55%), and assisted with naloxone distribution to ED patients (64%). A minority assisted with ED-initiated buprenorphine (EDIB) programs (27%). Most (91%) provided services to patients after they were discharged from the ED. Barriers to implementation included lack of outpatient referral sources, barriers to initiating MOUD, stigma at the clinician and system level, and lack of ongoing PSS availability due to short-term grant funding. The majority of ED-based PSSs were funded through time-limited grants, and short-term grant funding was identified as a barrier for ED PSS programs. There was consistency among sites in the involvement of PSSs in facilitation of transitions of SUD care, coordination of follow-up after ED discharge, and PSS involvement in naloxone distribution.","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"77 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140579197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Healthcare staff’s perspectives on long-acting injectable buprenorphine treatment: a qualitative interview study 医护人员对长效注射丁丙诺啡治疗的看法:定性访谈研究
IF 3.7 2区 医学
Addiction Science & Clinical Practice Pub Date : 2024-04-05 DOI: 10.1186/s13722-024-00458-6
Johan Nordgren, Bodil Monwell, Björn Johnson, Nina Veetnisha Gunnarsson, Andrea Johansson Capusan
{"title":"Healthcare staff’s perspectives on long-acting injectable buprenorphine treatment: a qualitative interview study","authors":"Johan Nordgren, Bodil Monwell, Björn Johnson, Nina Veetnisha Gunnarsson, Andrea Johansson Capusan","doi":"10.1186/s13722-024-00458-6","DOIUrl":"https://doi.org/10.1186/s13722-024-00458-6","url":null,"abstract":"Long-acting injectable buprenorphine (LAIB) formulations are a novel treatment approach in opioid agonist treatment (OAT), which provide patients with a steady dose administered weekly or monthly and thus reduce the need for frequent clinic visits. Several studies have analyzed patient experiences of LAIB but the perspective of OAT staff is unknown. This study aimed to explore how healthcare staff working in OAT clinics in Sweden perceive and manage treatment with LAIB. Individual qualitative interviews were conducted with OAT physicians (n = 10) in tandem with nine focus group sessions with OAT nurses and other staff categories (n = 41). The data was analyzed with thematic text analysis. Five central themes were identified in the data: (1) advantages and disadvantages of LAIB, (2) patient categories that may or may not need LAIB, (3) patients’ degrees of medication choice, (4) keeping tabs, control and treatment alliance, and (5) LAIB’s impact on risk and enabling environments in OAT. Overall staff found more advantages than disadvantages with LAIB and considered that patients with ongoing substance use and low adherence were most likely to benefit from LAIB. However, less frequent visits were viewed as problematic in terms of developing a treatment alliance and being able to keep tabs on patients’ clinical status. Clinics differed regarding patients' degrees of choice in medication, which varied from limited to extensive. LAIB affected both risk and enabling environments in OAT. LAIB may strengthen the enabling environment in OAT for some patients by reducing clinic visits, exposure to risk environments, and the pressure to divert medication. A continued discussion about the prerequisites and rationale for LAIB implementation is needed in policy and practice.","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"270 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140579041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Psychometric properties of the cannabis abuse screening test (CAST) in a sample of Moroccans with cannabis use 吸食大麻的摩洛哥人样本中大麻滥用筛查测试 (CAST) 的心理计量特性
IF 3.7 2区 医学
Addiction Science & Clinical Practice Pub Date : 2024-04-03 DOI: 10.1186/s13722-024-00459-5
Hicham El Malki, Salma Ghofrane Moutawakkil, Abdelfettah El-Ammari, Mohammed El Amine Ragala, Jaouad El Hilaly, Samir El Gnaoui, Fatima El Houari, Karima El Rhazi, Btissame Zarrouq
{"title":"Psychometric properties of the cannabis abuse screening test (CAST) in a sample of Moroccans with cannabis use","authors":"Hicham El Malki, Salma Ghofrane Moutawakkil, Abdelfettah El-Ammari, Mohammed El Amine Ragala, Jaouad El Hilaly, Samir El Gnaoui, Fatima El Houari, Karima El Rhazi, Btissame Zarrouq","doi":"10.1186/s13722-024-00459-5","DOIUrl":"https://doi.org/10.1186/s13722-024-00459-5","url":null,"abstract":"The Cannabis Abuse Screening Test (CAST) is a widely used screening tool for identifying patterns of cannabis use that have negative health or social consequences for both the user and others involved. This brief screening instrument has been translated into multiple languages, and several studies examining its psychometric properties have been published. However, studies on the factorial validity and psychometric properties of a Moroccan version of the CAST are not yet available. The objective of this study is to validate the CAST, translated, and adapted to the Moroccan Arabic dialect among persons with cannabis use. A total of 370 participants from an addictology center in Fez City, were selected over two phases to form the study sample. First, in phase I, exploratory factor analysis was employed to evaluate the factor structure in the pilot sample (n1 = 150). Subsequently, in the second phase (Phase II), confirmatory factor analysis was utilized to confirm this structure in the validation sample (n2 = 220). All statistical analyses were carried out using the R program. The CFA unveiled a three-factor structure that showed a good overall fit (χ2/df = 2.23, RMSEA = 0.07, SRMR = 0.02, CFI = 0.99, NFI = 0.98) and satisfactory local parameters (standardized factor loadings between 0.72 and 0.88). The model demonstrates satisfactory reliability and convergent validity, as evidenced by the acceptable values of composite reliability (CR) (0.76–0.88) and average variance extracted (AVE) (0.62–0.78), respectively. The square roots of the AVE exceeded the correlations of the factor pairs, and the heterotrait-monotrait (HTMT) ratio of the correlation values was below 0.85, indicating acceptable discriminant validity. The reliability, convergent validity, and discriminant validity tests all demonstrated that the Moroccan version of the CAST performed well and can be considered a valid tool for screening of problematic cannabis use.","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"271 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140579199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cost of start-up activities to implement a community-level opioid overdose reduction intervention in the HEALing Communities Study 在 HEALing 社区研究中实施社区一级减少阿片类药物过量干预措施的启动活动成本
IF 3.7 2区 医学
Addiction Science & Clinical Practice Pub Date : 2024-04-02 DOI: 10.1186/s13722-024-00454-w
Iván D. Montoya, Colleen Watson, Arnie Aldridge, Danielle Ryan, Sean M. Murphy, Brenda Amuchi, Kathryn E. McCollister, Bruce R. Schackman, Joshua L. Bush, Drew Speer, Kristin Harlow, Stephen Orme, Gary A. Zarkin, Mathieu Castry, Eric E. Seiber, Joshua A. Barocas, Benjamin P. Linas, Laura E. Starbird
{"title":"Cost of start-up activities to implement a community-level opioid overdose reduction intervention in the HEALing Communities Study","authors":"Iván D. Montoya, Colleen Watson, Arnie Aldridge, Danielle Ryan, Sean M. Murphy, Brenda Amuchi, Kathryn E. McCollister, Bruce R. Schackman, Joshua L. Bush, Drew Speer, Kristin Harlow, Stephen Orme, Gary A. Zarkin, Mathieu Castry, Eric E. Seiber, Joshua A. Barocas, Benjamin P. Linas, Laura E. Starbird","doi":"10.1186/s13722-024-00454-w","DOIUrl":"https://doi.org/10.1186/s13722-024-00454-w","url":null,"abstract":"Communities That HEAL (CTH) is a novel, data-driven community-engaged intervention designed to reduce opioid overdose deaths by increasing community engagement, adoption of an integrated set of evidence-based practices, and delivering a communications campaign across healthcare, behavioral-health, criminal-legal, and other community-based settings. The implementation of such a complex initiative requires up-front investments of time and other expenditures (i.e., start-up costs). Despite the importance of these start-up costs in investment decisions to stakeholders, they are typically excluded from cost-effectiveness analyses. The objective of this study is to report a detailed analysis of CTH start-up costs pre-intervention implementation and to describe the relevance of these data for stakeholders to determine implementation feasibility. This study is guided by the community perspective, reflecting the investments that a real-world community would need to incur to implement the CTH intervention. We adopted an activity-based costing approach, in which resources related to hiring, training, purchasing, and community dashboard creation were identified through macro- and micro-costing techniques from 34 communities with high rates of fatal opioid overdoses, across four states—Kentucky, Massachusetts, New York, and Ohio. Resources were identified and assigned a unit cost using administrative and semi-structured-interview data. All cost estimates were reported in 2019 dollars. State-level average and median start-up cost (representing 8–10 communities per state) were $268,657 and $175,683, respectively. Hiring and training represented 40%, equipment and infrastructure costs represented 24%, and dashboard creation represented 36% of the total average start-up cost. Comparatively, hiring and training represented 49%, purchasing costs represented 18%, and dashboard creation represented 34% of the total median start-up cost. We identified three distinct CTH hiring models that affected start-up costs: hospital-academic (Massachusetts), university-academic (Kentucky and Ohio), and community-leveraged (New York). Hiring, training, and purchasing start-up costs were lowest in New York due to existing local infrastructure. Community-based implementation similar to the New York model may have lower start-up costs due to leveraging of existing infrastructure, relationships, and support from local health departments.","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"95 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140579040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hospitalization is a missed opportunity for HIV screening, pre-exposure prophylaxis, and treatment. 住院治疗会错过 HIV 筛查、接触前预防和治疗的机会。
IF 3.7 2区 医学
Addiction Science & Clinical Practice Pub Date : 2024-03-26 DOI: 10.1186/s13722-024-00451-z
William Bradford, Hana Akselrod, John Bassler, Kelly W Gagnon, Greer Burkholder, Joseph Edward Carpenter, Alaina Steck, Jillian Catalanotti, Irene Kuo, Keanan McGonigle, William Mai, Melissa Notis, Christopher Brokus, Sarah Kattakuzhy, Elana Rosenthal, Ellen F Eaton
{"title":"Hospitalization is a missed opportunity for HIV screening, pre-exposure prophylaxis, and treatment.","authors":"William Bradford, Hana Akselrod, John Bassler, Kelly W Gagnon, Greer Burkholder, Joseph Edward Carpenter, Alaina Steck, Jillian Catalanotti, Irene Kuo, Keanan McGonigle, William Mai, Melissa Notis, Christopher Brokus, Sarah Kattakuzhy, Elana Rosenthal, Ellen F Eaton","doi":"10.1186/s13722-024-00451-z","DOIUrl":"10.1186/s13722-024-00451-z","url":null,"abstract":"<p><strong>Background: </strong>Hospitalization is a \"reachable moment\" for people who inject drugs (PWID), but preventive care including HIV testing, prevention and treatment is rarely offered within inpatient settings.</p><p><strong>Methods: </strong>We conducted a multisite, retrospective cohort study of patients with opioid use disorder with infectious complications of injection drug use hospitalized between 1/1/2018-12/31/2018. We evaluated HIV care continuum outcomes using descriptive statistics and hypothesis tests for intergroup differences.</p><p><strong>Results: </strong>322 patients were included. Of 300 patients without known HIV, only 2 had a documented discussion of PrEP, while only 1 was prescribed PrEP on discharge. Among the 22 people with HIV (PWH), only 13 (59%) had a viral load collected during admission of whom all were viremic and 10 (45%) were successfully linked to care post-discharge. Rates of readmission, Medicaid or uninsured status, and unstable housing were high in both groups.</p><p><strong>Discussion: </strong>We observed poor provision of HIV testing, PrEP and other HIV services for hospitalized PWID across multiple U.S. medical centers. Future initiatives should focus on providing this group with comprehensive HIV testing and treatment services through a status neutral approach.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"19 1","pages":"22"},"PeriodicalIF":3.7,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10964564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140289650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Project CHARIOT: study protocol for a hybrid type 1 effectiveness-implementation study of comprehensive tele-harm reduction for engagement of people who inject drugs in HIV prevention services. CHARIOT项目:针对注射吸毒者参与艾滋病预防服务的综合远程伤害减少的第1类混合有效性-实施研究的研究方案。
IF 3.7 2区 医学
Addiction Science & Clinical Practice Pub Date : 2024-03-25 DOI: 10.1186/s13722-024-00447-9
Tyler S Bartholomew, Marina Plesons, David P Serota, Elizabeth Alonso, Lisa R Metsch, Daniel J Feaster, Jessica Ucha, Edward Suarez, David W Forrest, Teresa A Chueng, Katrina Ciraldo, Jimmie Brooks, Justin D Smith, Joshua A Barocas, Hansel E Tookes
{"title":"Project CHARIOT: study protocol for a hybrid type 1 effectiveness-implementation study of comprehensive tele-harm reduction for engagement of people who inject drugs in HIV prevention services.","authors":"Tyler S Bartholomew, Marina Plesons, David P Serota, Elizabeth Alonso, Lisa R Metsch, Daniel J Feaster, Jessica Ucha, Edward Suarez, David W Forrest, Teresa A Chueng, Katrina Ciraldo, Jimmie Brooks, Justin D Smith, Joshua A Barocas, Hansel E Tookes","doi":"10.1186/s13722-024-00447-9","DOIUrl":"10.1186/s13722-024-00447-9","url":null,"abstract":"<p><strong>Background: </strong>People who inject drugs (PWID) remain a high priority population under the federal Ending the HIV Epidemic initiative with 11% of new HIV infections attributable to injection drug use. There is a critical need for innovative, efficacious, scalable, and community-driven models of healthcare in non-stigmatizing settings for PWID. We seek to test a Comprehensive-TeleHarm Reduction (C-THR) intervention for HIV prevention services delivered via a syringe services program (SSP).</p><p><strong>Methods: </strong>The CHARIOT trial is a hybrid type I effectiveness-implementation study using a parallel two-arm randomized controlled trial design. Participants (i.e., PWID; n = 350) will be recruited from a syringe services program (SSP) in Miami, Florida. Participants will be randomized to receive either C-THR or non-SSP clinic referral and patient navigation. The objectives are: (1) to determine if the C-THR intervention increases engagement in HIV prevention (i.e., HIV pre-exposure prophylaxis; PrEP or medications for opioid use disorder; MOUD) compared to non-SSP clinic referral and patient navigation, (2) to examine the long-term effectiveness and cost-effectiveness of the C-THR intervention, and (3) to assess the barriers and facilitators to implementation and sustainment of the C-THR intervention. The co-primary outcomes are PrEP or MOUD engagement across follow-up at 3, 6, 9 and 12 months. For PrEP, engagement is confirmed by tenofovir on dried blood spot or cabotegravir injection within the previous 8 weeks. For MOUD, engagement is defined as screening positive for norbuprenorphine or methadone on urine drug screen; or naltrexone or buprenorphine injection within the previous 4 weeks. Secondary outcomes include PrEP adherence, engagement in HCV treatment and sustained virologic response, and treatment of sexually transmitted infections. The short and long term cost-effectiveness analyses and mixed-methods implementation evaluation will provide compelling data on the sustainability and possible impact of C-THR on comprehensive HIV prevention delivered via SSPs.</p><p><strong>Discussion: </strong>The CHARIOT trial will be the first to our knowledge to test the efficacy of an innovative, peer-led telehealth intervention with PWID at risk for HIV delivered via an SSP. This innovative healthcare model seeks to transform the way PWID access care by bypassing the traditional healthcare system, reducing multi-level barriers to care, and meeting PWID where they are.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT05897099. Trial registry name: Comprehensive HIV and Harm Prevention Via Telehealth (CHARIOT). Registration date: 06/12/2023.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"19 1","pages":"21"},"PeriodicalIF":3.7,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10964520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140289651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Provider perceptions of systems-level barriers and facilitators to utilizing family-based treatment approaches in adolescent and young adult opioid use disorder treatment. 提供者对在青少年和年轻成人阿片类药物使用障碍治疗中采用基于家庭的治疗方法的系统级障碍和促进因素的看法。
IF 3.7 2区 医学
Addiction Science & Clinical Practice Pub Date : 2024-03-21 DOI: 10.1186/s13722-024-00437-x
Melissa Pielech, Crosby Modrowski, Jasper Yeh, Melissa A Clark, Brandon D L Marshall, Francesca L Beaudoin, Sara J Becker, Robert Miranda
{"title":"Provider perceptions of systems-level barriers and facilitators to utilizing family-based treatment approaches in adolescent and young adult opioid use disorder treatment.","authors":"Melissa Pielech, Crosby Modrowski, Jasper Yeh, Melissa A Clark, Brandon D L Marshall, Francesca L Beaudoin, Sara J Becker, Robert Miranda","doi":"10.1186/s13722-024-00437-x","DOIUrl":"10.1186/s13722-024-00437-x","url":null,"abstract":"<p><strong>Background: </strong>Amidst increasing opioid-related fatalities in adolescents and young adults (AYA), there is an urgent need to enhance the quality and availability of developmentally appropriate, evidence-based treatments for opioid use disorder (OUD) and improve youth engagement in treatment. Involving families in treatment planning and therapy augments medication-based OUD treatment for AYA by increasing treatment engagement and retention. Yet, uptake of family-involved treatment for OUD remains low. This study examined systems-level barriers and facilitators to integrating families in AYA OUD treatment in Rhode Island.</p><p><strong>Methods: </strong>An online survey was administered to clinic leaders and direct care providers who work with AYA in programs that provide medication and psychosocial treatments for OUD. The survey assessed attitudes towards and experiences with family-based treatment, barriers and facilitators to family-based treatment utilization, as well as other available treatment services for AYA and family members. Findings were summarized using descriptive statistics.</p><p><strong>Results: </strong>A total of 104 respondents from 14 distinct treatment programs completed the survey. Most identified as White (72.5%), female (72.7%), and between 25 and 44 years of age (59.4%). Over half (54.1%) of respondents reported no experience with family based treatment and limited current opportunities to involve families. Barriers perceived as most impactful to adopting family-based treatment were related to limited available resources (i.e. for staff training, program expansion) and lack of prioritization of family-based treatment in staff productivity requirements. Barriers perceived as least impactful were respondent beliefs and attitudes about family-based treatment (e.g., perception of the evidence strength and quality of family-based treatment, interest in implementing family-based treatment) as well as leadership support of family-based treatment approaches. Respondents identified several other gaps in availability of comprehensive treatment services, especially for adolescents (e.g. services that increase social recovery capital).</p><p><strong>Conclusions: </strong>Family-based treatment opportunities for AYA with OUD in Rhode Island are limited. Affordable and accessible training programs are needed to increase provider familiarity and competency with family-based treatment. Implementation of programming to increase family involvement in treatment (i.e. psychoeducational and skills-based groups for family members) rather than adopting a family-based treatment model may be a more feasible step to better meet the needs of AYA with OUD.</p><p><strong>Trial registration: </strong>not applicable.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"19 1","pages":"20"},"PeriodicalIF":3.7,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10958911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140186271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Treatment of alcohol use disorder in patients with alcohol-associated liver disease: Innovative approaches and a call to action 治疗酒精相关肝病患者的酒精使用障碍:创新方法和行动呼吁
IF 3.7 2区 医学
Addiction Science & Clinical Practice Pub Date : 2024-03-19 DOI: 10.1186/s13722-024-00448-8
Lamia Y. Haque, Paola Zuluaga, Robert Muga, Daniel Fuster
{"title":"Treatment of alcohol use disorder in patients with alcohol-associated liver disease: Innovative approaches and a call to action","authors":"Lamia Y. Haque, Paola Zuluaga, Robert Muga, Daniel Fuster","doi":"10.1186/s13722-024-00448-8","DOIUrl":"https://doi.org/10.1186/s13722-024-00448-8","url":null,"abstract":"Alcohol-associated liver disease is currently the leading cause of liver transplantation and liver deaths both in Europe and the United States. Efficacious treatments exist for alcohol use disorder, but they are seldomly prescribed for patients who need them. Besides, the presence of liver cirrhosis can complicate pharmacological treatment choices. In this review, we discuss established and innovative treatment strategies to treat unhealthy alcohol use in patients with alcohol-associated liver disease. We also describe the experience of our own institutions, Hospital Universitari Germans Trias i Pujol in Badalona (Spain) and Yale-New Haven Health and Yale Medicine (Connecticut. United States of America).","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"33 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140168994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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