A Comprehensive Disease Management Program for Medically-Complex Substance Users

Substance-related Disorder Clinical Trial

Official title:

A Comprehensive Disease Management Program for Medically-Complex Substance Users

Clinical Trial Details — Status: Withdrawn

Administrative data

• NCT number: NCT00865956
• Other study ID #: NA_00015261
• Status: Withdrawn
• Phase: N/A
• Start date: March 2008
• Est. completion date: June 2010

Study information

• Verified date: October 2018
• Source: Johns Hopkins University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Disease management (DM) programs are being increasingly utilized by health plans to coordinate care, improve quality of care, and control costs in chronically ill individuals. DM programs for specific medical conditions, such as diabetes mellitus, congestive heart failure, and asthma, have demonstrated improvements in health outcomes and a number of studies have found economic benefits to these programs as well. There are fewer data evaluating multi-disease DM programs, and results have been mixed. Additionally, data on such programs specifically targeting substance-using populations are limited, although they are promising. Prior utilization and hospitalization data from Johns Hopkins Hospital, Johns Hopkins Health Care, and Priority Partners Managed Care Organization (PPMCO) suggest that a substantial portion of high-utilizing, high-cost, medically complex patients have a substance use diagnosis.

The investigators hypothesize that a comprehensive DM program for medically-complex substance users with a history of hospitalization, consisting of intensive nurse case management along with behavioral incentives to reinforce engagement in primary care, can decrease inpatient days and costs, as well as improve outcomes for substance use, depression, and physical and mental functioning. The investigators will compare the case management/behavioral incentives intervention to usual care among a group of medically-complex, substance-using, PPMCO enrollees. Usual care will include access to all existing Priority Partners care management programs, and usual The investigators believe that this research will make an important contribution to the development of models of chronic care that improve health and promote the best use of health care resources. Additionally, the investigators believe this project will promote the study and development of systems to improve the health of substance-using adults, an underserved and often marginalized group.

Recruitment information / eligibility

• Status: Withdrawn
• Enrollment: 0
• Est. completion date: June 2010
• Est. primary completion date: June 2010
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Age over 18

• Continuous enrollment in Priority Partners MCO for past 12 months

• Primary care site East Baltimore Medical Center (EBMC)

• PPMCO substance abuse flag other than nicotine only within past 24 months

Exclusion Criteria:

• currently enrolled in PPMCO Care Management

Related Conditions & MeSH terms

• Substance-related Disorder
• Substance-Related Disorders

Intervention

Behavioral:
• Contingency Management
Rite Aid vouchers (stepped value) for reinforcement of adherence to primary care

Other:
• Case management
Nurse case manager assigned to participant

Locations

Country	Name	City	State
United States	East Baltimore Medical Center	Baltimore	Maryland

Sponsors (2)

Lead Sponsor	Collaborator
Johns Hopkins University	Johns Hopkins Community Physicians

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Per member per month expenditures		12 months
Secondary	Hospitalization days		12 months
Secondary	Outpatient visits		12 months
Secondary	Emergency Department visits		12 months
Secondary	Substance use disorder treatment		12 months
Secondary	Self-reported substance use		12 months
Secondary	Physical and mental functioning		12 months
Secondary	Depression		12 months