Clinical Trial Details
— Status: Completed
Administrative data
NCT number |
NCT05252221 |
Other study ID # |
1564446 |
Secondary ID |
R01AA028211 |
Status |
Completed |
Phase |
N/A
|
First received |
|
Last updated |
|
Start date |
September 14, 2021 |
Est. completion date |
August 31, 2023 |
Study information
Verified date |
April 2024 |
Source |
Kaiser Permanente |
Contact |
n/a |
Is FDA regulated |
No |
Health authority |
|
Study type |
Interventional
|
Clinical Trial Summary
This pragmatic, cluster-randomized trial in adult primary care clinics in a healthcare system
with a diverse membership will examine the effectiveness of an innovative, multi-faceted
intervention, the Addiction Telemedicine Consultant (ATC) service using clinical pharmacists
to facilitate alcohol use problems and alcohol use disorder (AUD) pharmacotherapy and
specialty addiction treatment entry.
Description:
This study will examine the effectiveness of a multi-faceted intervention - the Addiction
Telemedicine Consultant service, or "ATC," which consists of:
- A 1-hour information session for Primary Care Providers (PCP) about alcohol problems;
including alcohol use disorder (AUD) and AUD pharmacotherapy, provided by the research
team in collaboration with Kaiser Permanente Northern California (KPNC) addiction
medicine and clinical pharmacy leadership. Along with a post session evaluation via
survey monkey.
- PCP access to expert addiction medicine consultation by KPNC clinical pharmacists, via
telephone, videoconference, and secure messaging - during primary care patient visits
with the patient present, or asynchronously without the patient present.
- Real-time, in-exam-room consultations may include clinical pharmacist assistance
with patient assessment, psychoeducation, motivational interventions, and
facilitation of patient engagement in addiction treatment.
- Asynchronous consultations without the patient present may include clinical
pharmacist advice regarding patient-specific treatment options, including
pharmacotherapy, psychosocial treatment, and combined treatments,
- Ongoing technical assistance for PCPs, including coaching and troubleshooting on alcohol
problems assessment and AUD medication prescribing and treatment entry facilitation,
from the ATC consultants, as needed.
This study will use electronic health record (EHR) data to examine treatment arm effects on
implementation outcomes and patient outcomes recorded during the course of regular clinical
care, and health services utilization over two years. The study will accomplish this through
the following specific aims:
Aim 1: To compare the ATC and Usual Care arms on implementation outcomes: AUD medication
prescription order rates and specialty addiction treatment referrals over two years.
Aim 2: To compare the ATC and UC arms on patient outcomes: AUD medication fills, addiction
treatment initiation, alcohol use (quantity/frequency), and services utilization over two
years.
Aim 3: To understand characteristics associated with ATC implementation, and barriers and
facilitators of AUD medication prescription. We will examine provider characteristics
(including potential race/ethnic and gender disparities) associated with ATC implementation
outcomes using EHR and semi-structured qualitative interviews with PCPs and explore how the
different elements of ATC (video consult, telephone, and email) facilitate its
implementation. Provider characteristics and EHR portions of this aim involve data only.