Primary Care Linkage for Addiction Treatment

(Linkage Trial)

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Kaiser Permanente

Disqualifiers: Dementia, Mental retardation, Psychotic, Suicidal, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 6

Duration: 3 months

504 Participants Needed

Trial Summary

What is the purpose of this trial?

This component of a larger Center of Research Excellence Grant improves treatment for drug abuse by developing effective linkages between specialty drug treatment and primary health care.

Do I need to stop my current medications for the trial?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the Linkage patient activation treatment for addiction?

Research shows that the Recovery Management Checkups intervention, which is similar to the Linkage treatment, helped more patients enter and stay in addiction treatment compared to usual referrals. This approach also reduced drug use over six months, suggesting that assertive linking methods in primary care can be effective for addiction treatment. ^{1 2 3 4 5}

Is the Primary Care Linkage for Addiction Treatment safe for humans?

The available research does not specifically address safety concerns for the Primary Care Linkage for Addiction Treatment, but it focuses on improving patient engagement and treatment entry, which are generally safe processes. ^{1 3 4 6 7}

How is the Primary Care Linkage for Addiction Treatment different from other treatments?

The Primary Care Linkage for Addiction Treatment is unique because it uses the electronic health record and a patient activation approach to engage patients with addiction treatment, which is the first of its kind. This method aims to improve patient self-management and healthcare engagement, setting it apart from traditional treatments that may not focus on these aspects. ^{1 3 6 8 9}

Research Team

Constance M Weisner, DrPH, LCSW

Principal Investigator

Kaiser Permanente

Eligibility Criteria

This trial is for adults at the Kaiser Permanente San Francisco Chemical Dependency Recovery Program who have finished at least 2 weeks of treatment for substance use disorders, including addiction and alcoholism. Those with dementia, mental retardation, or current psychosis or suicidal tendencies cannot participate.

Inclusion Criteria

I am an adult who has completed 2 weeks at Kaiser's San Francisco addiction recovery program.

Exclusion Criteria

Patients with a diagnosis of dementia

Patients with a diagnosis of mental retardation

Patients who are actively psychotic

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive Usual Care or Usual Care plus Linkage intervention, including therapy groups, individual counseling, and medical education or activation sessions

3 months

Follow-up

Participants are monitored for patient engagement, substance use, mental health outcomes, and health care utilization

24 months

Follow-up interviews at 6, 12, and 24 months

Treatment Details

Interventions

• Linkage patient activation intervention

Trial Overview The study tests a 'linkage patient activation intervention' designed to improve connections between specialty drug treatment and primary health care as part of enhancing overall drug abuse treatment.

Participant Groups

Group I: Linkage patient activation intervention Experimental Treatment 1 Intervention

Usual Care with the exception that the six 45-min Linkage patient activation education groups replaced the six 45-min Usual Care medical education groups, plus a linkage phone call (and/or a facilitated email) with the patient, clinician, and Primary Care physician.

Group II: Usual Care Active Control 1 Intervention

Usual CD treatment, including therapy groups and individual counseling sessions, and six 45-min medical education groups. Physician appointments, pharmacotherapy, and SUD medications were be available as needed.

Who Is Running the Clinical Trial?

Kaiser Permanente

Lead Sponsor

Trials

563

Recruited

27,400,000+

Kaiser Foundation Research Institute

Collaborator

Trials

28

Recruited

21,300+

References

1. United States pubmed.ncbi.nlm.nih.gov

Linking Individuals with Substance Use Disorders (SUDs) in Primary Care to SUD Treatment: the Recovery Management Checkups-Primary Care (RMC-PC) Pilot Study. [2022]

2. England pubmed.ncbi.nlm.nih.gov

Assessing the service linkages of substance abuse agencies with mental health and primary care organizations. [2019]

3. United States pubmed.ncbi.nlm.nih.gov

Linkage with primary medical care in a prospective cohort of adults with addictions in inpatient detoxification: room for improvement. [2018]

4. United States pubmed.ncbi.nlm.nih.gov

The Integrating Medications for Addiction Treatment (IMAT) Index: A measure of capability at the organizational level. [2021]

5. England pubmed.ncbi.nlm.nih.gov

Primary medical care and reductions in addiction severity: a prospective cohort study. [2007]

6. United States pubmed.ncbi.nlm.nih.gov

Examination of the Effects of an Intervention Aiming to Link Patients Receiving Addiction Treatment With Health Care: The LINKAGE Clinical Trial. [2019]

7. England pubmed.ncbi.nlm.nih.gov

Initiating buprenorphine treatment for opioid use disorder during short-term in-patient 'detoxification': a randomized clinical trial. [2021]

8. United States pubmed.ncbi.nlm.nih.gov

Office-Based Addiction Treatment in Primary Care: Approaches That Work. [2018]

9. England pubmed.ncbi.nlm.nih.gov

Receipt of addiction treatment as a consequence of a brief intervention for drug use in primary care: a randomized trial. [2019]