N/A
N=88
Substance Use Treatment and Recovery Team (START)
Opioid-use Disorder · Opioid-Related Disorders · Alcohol Use Disorder · Alcohol-Related Disorders
Bottom Line
View on ClinicalTrials.gov: NCT04314648 ↗Enrolled (actual)
88
Serious AEs
0.0%
Results posted
Apr 2023
Primary outcome: Primary: Number of Patients With In-hospital Initiation of Medication for OUD or AUD — 22; 9 Participants — p=<.001
Study Design & Population
- Study type
- Interventional
- Phase
- N/A
- Interventions
- Substance Use Treatment and Recovery Team (START) (Behavioral)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- RAND
- Primary completion
- Sep 2021
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Number of Patients With In-hospital Initiation of Medication for OUD or AUD |
22; 9 | <.001 sig |
| PRIMARY Number of Patients With Linkage to Follow-up Care for OUD or AUD |
24; 20 | <.01 sig |
| PRIMARY Number of Patients With Heavy Drinking in Past 30-days at Follow-up Among Patients With Alcohol Use Disorder |
5; 9 | .64 |
| PRIMARY Number of Patients With Any Days of Opioid Use in Past 30-days at Follow-up Among Patients With Opioid Use Disorder |
5; 5 | .35 |
| PRIMARY Average Number of Days of Alcohol Use in Past 30-Days at Follow-Up Among Patients With Alcohol Use Disorder |
4.08; 6.24 | .43 |
| PRIMARY Average Number of Drinks Per Day in Past 30-days at Follow-up Among Patients With Alcohol Use Disorder |
9.82; 7.00 | .44 |
| SECONDARY Number of Patients Readmitted to Cedars-Sinai Medical Center (CSMC) Within 90 Days After Discharge |
7; 8 | .77 |
Summary
Despite high prevalence, few hospitalized inpatients with opioid or alcohol use disorders (OAUDs) receive evidence-based treatments while in the hospital or get linked with appropriate follow-up care, leading to poor clinical outcomes and high readmission rates and costs. The purpose of this study is to evaluate whether a physician and care manager with addiction expertise, both members of the Substance Abuse Treatment and Recovery Team (START), can help improve initiation of treatment in the hospital and linkage to follow-up care upon discharge. START members have expertise in the treatment of substance use disorders.
START will work with the medical or surgical team to ensure appropriate care is received. That care will include therapy, focused discharge planning, and medication treatment options. START will also help establish a follow-up plan for continuation of treatment after hospital discharge.
To assess feasibility, the study will enroll 80 patients admitted to the hospital over 5 months in a pilot randomized clinical trial and collect baseline and 1-month follow-up data. To determine acceptability, the study will conduct semi-structured interviews with 40 providers. Results of this pilot study will inform a larger clinical trial.
Eligibility Criteria
Inclusion Criteria
- Inpatient at CSMC
- Age 18 and older
- Screens positive for moderate to severe OAUDs based on the alcohol and opioid questions on the
- World Health Organization (WHO) Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST).
- Speaks English as primary language
- The usual attending physician agrees to patient's participation
- Has decision-making capacity and is not gravely disabled
Exclusion Criteria
- Currently receiving FDA-approved medication treatment for an opioid or alcohol use disorder
- Gravely disabled (per clinical judgement)
- Does not have decision-making capacity (per clinical judgement)
Data sourced from ClinicalTrials.gov (NCT04314648). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.