Cargando…

The use of patient navigation to transition detoxification patients to substance use treatment in the Alaska Interior

OBJECTIVES: Detoxification clinics manage acute intoxication and withdrawal from alcohol and other drugs. At discharge, patients are referred to treatment, yet many are readmitted to detoxification, creating a “revolving door” of discharges and admissions. This pattern disproportionately affects som...

Descripción completa

Detalles Bibliográficos
Autores principales: Running Bear, Ursula, Poole, Erin M., Muller, Clemma, Hanson, Jessica D., Noonan, Carolyn, Trojan, Jodi, Rosenman, Robert, Manson, Spero M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10448195/
https://www.ncbi.nlm.nih.gov/pubmed/37635913
http://dx.doi.org/10.1016/j.puhip.2023.100418
_version_ 1785094676787757056
author Running Bear, Ursula
Poole, Erin M.
Muller, Clemma
Hanson, Jessica D.
Noonan, Carolyn
Trojan, Jodi
Rosenman, Robert
Manson, Spero M.
author_facet Running Bear, Ursula
Poole, Erin M.
Muller, Clemma
Hanson, Jessica D.
Noonan, Carolyn
Trojan, Jodi
Rosenman, Robert
Manson, Spero M.
author_sort Running Bear, Ursula
collection PubMed
description OBJECTIVES: Detoxification clinics manage acute intoxication and withdrawal from alcohol and other drugs. At discharge, patients are referred to treatment, yet many are readmitted to detoxification, creating a “revolving door” of discharges and admissions. This pattern disproportionately affects some groups such as Alaska Native and American Indian (AN/AI) people. The primary goals of this study are to: 1) test the effectiveness of a patient navigation intervention to increase rates of transition to alcohol treatment following detoxification, and 2) prevent readmission to detoxification within 12-months. The secondary goal is a cost-effectiveness and cost-benefit evaluation of patient navigation. STUDY DESIGN: This randomized controlled comparative effectiveness trial plans to recruit 440 patients (∼70% AN/AI) admitted to alcohol detoxification. We collaborated with Fairbanks Native Association (FNA) to select an appropriate intervention, control condition, and other study-related decisions. Here, we describe intervention development, study design, challenges encountered during implementation, and collaborative processes to identify solutions. METHODS: Participants are equally randomized to the control (one motivational interviewing session) or intervention (one motivational interviewing session plus up to four weeks of patient navigation). The primary outcomes are successful transition to alcohol treatment within 30-days after discharge and detoxification readmission within 12-months. The secondary outcome is health-related quality of life. CONCLUSION: Patient navigation is successful in other settings and for other health conditions. It may assist in overcoming barriers to successful transition to substance use treatment and may augment interventions, such as motivational interviewing, that are less resource-intensive but may not be optimally effective by themselves. CLINICALTRIALS.GOV IDENTIFIER: NCT03737864.
format Online
Article
Text
id pubmed-10448195
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-104481952023-08-25 The use of patient navigation to transition detoxification patients to substance use treatment in the Alaska Interior Running Bear, Ursula Poole, Erin M. Muller, Clemma Hanson, Jessica D. Noonan, Carolyn Trojan, Jodi Rosenman, Robert Manson, Spero M. Public Health Pract (Oxf) Original Research OBJECTIVES: Detoxification clinics manage acute intoxication and withdrawal from alcohol and other drugs. At discharge, patients are referred to treatment, yet many are readmitted to detoxification, creating a “revolving door” of discharges and admissions. This pattern disproportionately affects some groups such as Alaska Native and American Indian (AN/AI) people. The primary goals of this study are to: 1) test the effectiveness of a patient navigation intervention to increase rates of transition to alcohol treatment following detoxification, and 2) prevent readmission to detoxification within 12-months. The secondary goal is a cost-effectiveness and cost-benefit evaluation of patient navigation. STUDY DESIGN: This randomized controlled comparative effectiveness trial plans to recruit 440 patients (∼70% AN/AI) admitted to alcohol detoxification. We collaborated with Fairbanks Native Association (FNA) to select an appropriate intervention, control condition, and other study-related decisions. Here, we describe intervention development, study design, challenges encountered during implementation, and collaborative processes to identify solutions. METHODS: Participants are equally randomized to the control (one motivational interviewing session) or intervention (one motivational interviewing session plus up to four weeks of patient navigation). The primary outcomes are successful transition to alcohol treatment within 30-days after discharge and detoxification readmission within 12-months. The secondary outcome is health-related quality of life. CONCLUSION: Patient navigation is successful in other settings and for other health conditions. It may assist in overcoming barriers to successful transition to substance use treatment and may augment interventions, such as motivational interviewing, that are less resource-intensive but may not be optimally effective by themselves. CLINICALTRIALS.GOV IDENTIFIER: NCT03737864. Elsevier 2023-08-06 /pmc/articles/PMC10448195/ /pubmed/37635913 http://dx.doi.org/10.1016/j.puhip.2023.100418 Text en © 2023 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Research
Running Bear, Ursula
Poole, Erin M.
Muller, Clemma
Hanson, Jessica D.
Noonan, Carolyn
Trojan, Jodi
Rosenman, Robert
Manson, Spero M.
The use of patient navigation to transition detoxification patients to substance use treatment in the Alaska Interior
title The use of patient navigation to transition detoxification patients to substance use treatment in the Alaska Interior
title_full The use of patient navigation to transition detoxification patients to substance use treatment in the Alaska Interior
title_fullStr The use of patient navigation to transition detoxification patients to substance use treatment in the Alaska Interior
title_full_unstemmed The use of patient navigation to transition detoxification patients to substance use treatment in the Alaska Interior
title_short The use of patient navigation to transition detoxification patients to substance use treatment in the Alaska Interior
title_sort use of patient navigation to transition detoxification patients to substance use treatment in the alaska interior
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10448195/
https://www.ncbi.nlm.nih.gov/pubmed/37635913
http://dx.doi.org/10.1016/j.puhip.2023.100418
work_keys_str_mv AT runningbearursula theuseofpatientnavigationtotransitiondetoxificationpatientstosubstanceusetreatmentinthealaskainterior
AT pooleerinm theuseofpatientnavigationtotransitiondetoxificationpatientstosubstanceusetreatmentinthealaskainterior
AT mullerclemma theuseofpatientnavigationtotransitiondetoxificationpatientstosubstanceusetreatmentinthealaskainterior
AT hansonjessicad theuseofpatientnavigationtotransitiondetoxificationpatientstosubstanceusetreatmentinthealaskainterior
AT noonancarolyn theuseofpatientnavigationtotransitiondetoxificationpatientstosubstanceusetreatmentinthealaskainterior
AT trojanjodi theuseofpatientnavigationtotransitiondetoxificationpatientstosubstanceusetreatmentinthealaskainterior
AT rosenmanrobert theuseofpatientnavigationtotransitiondetoxificationpatientstosubstanceusetreatmentinthealaskainterior
AT mansonsperom theuseofpatientnavigationtotransitiondetoxificationpatientstosubstanceusetreatmentinthealaskainterior
AT runningbearursula useofpatientnavigationtotransitiondetoxificationpatientstosubstanceusetreatmentinthealaskainterior
AT pooleerinm useofpatientnavigationtotransitiondetoxificationpatientstosubstanceusetreatmentinthealaskainterior
AT mullerclemma useofpatientnavigationtotransitiondetoxificationpatientstosubstanceusetreatmentinthealaskainterior
AT hansonjessicad useofpatientnavigationtotransitiondetoxificationpatientstosubstanceusetreatmentinthealaskainterior
AT noonancarolyn useofpatientnavigationtotransitiondetoxificationpatientstosubstanceusetreatmentinthealaskainterior
AT trojanjodi useofpatientnavigationtotransitiondetoxificationpatientstosubstanceusetreatmentinthealaskainterior
AT rosenmanrobert useofpatientnavigationtotransitiondetoxificationpatientstosubstanceusetreatmentinthealaskainterior
AT mansonsperom useofpatientnavigationtotransitiondetoxificationpatientstosubstanceusetreatmentinthealaskainterior