Matching, Outcomes and Costs in Substance Abuse/Psychiatric Treatment

Dual Diagnosis Clinical Trial

Official title:

Matching, Outcomes and Costs in Substance Abuse/Psychiatric Treatment

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00012727
• Other study ID #: IIR 95-011
• Status: Completed
• Phase: Phase 2
• First received: March 14, 2001
• Last updated: April 6, 2015
• Est. completion date: August 2001

Study information

• Verified date: July 2005
• Source: VA Office of Research and Development
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Federal Government
• Study type: Interventional

Clinical Trial Summary

This project�s goal is to improve the quality of care and reduce treatment costs for veterans with substance abuse and psychiatric problems.

Description:

Background:

This project�s goal is to improve the quality of care and reduce treatment costs for veterans with substance abuse and psychiatric problems.

Objectives:

This project is evaluating a patient-treatment matching strategy to improve residential treatment for substance abuse patients with psychiatric disorders. Its immediate objective is to examine whether the matching strategy results in more effective and cost-effective treatment in VA programs. We hypothesize that patients with severe clinical problems will have better outcomes when they are matched to service-intensive programs; patients with moderate problems will have better outcomes when they are matched to programs having a lower intensity of services. For both patient groups, community treatment should prove to be more cost-effective than hospital treatment.

Methods:

The project utilized a stratified randomized design. We paired each of three VA hospital programs that treat dual diagnosis patients and are high on intensity with a nearby high-intensity community residential facility (CRF) that contracts with the VA. We also paired four VA hospital and four CRFs that are low on intensity. Veterans who applied for substance abuse treatment at VA facilities were randomly assigned to either the VA hospital or CRF. Patient assessments have been conducted at intake (N=230), discharge, and a 4-month follow-up. Primary outcomes are patients� severity of substance abuse and psychiatric problems. Secondary outcomes are patients� functional status and their VA and non-VA health care utilization and its costs.

Status:

Completed.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 236
• Est. completion date: August 2001
• Accepts healthy volunteers: No
• Gender: Both
• Age group: N/A and older

Eligibility

Inclusion Criteria:

Patients must be entering a VA inpatient substance abuse or psychiatric treatment program and be clinically judged as appropriate for inpatient or community residential care.

Exclusion Criteria:

Study Design

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Related Conditions & MeSH terms

• Dual Diagnosis

Intervention

Procedure:
• Matching Symptom Severity to Service Intensity

Locations

Country	Name	City	State
United States	North Florida/South Georgia Veterans Health System, Gainesville, FL	Gainesville	Florida
United States	Hampton VA Medical Center, Hampton, VA	Hampton	Virginia
United States	VA Long Beach Healthcare System, Long Beach, CA	Long Beach	California
United States	Oklahoma City VA Medical Center, Oklahoma City, OK	Oklahoma City	Oklahoma
United States	Omaha VA Nebraska-Western Iowa Health Care System, Omaha, NE	Omaha	Nebraska
United States	VA Palo Alto Health Care System, Palo Alto, CA	Palo Alto	California

Sponsors (1)

Lead Sponsor	Collaborator
VA Office of Research and Development

Country where clinical trial is conducted

United States, 

References & Publications (7)

Chen S, Barnett PG, Sempel JM, Timko C. Outcomes and costs of matching the intensity of dual-diagnosis treatment to patients' symptom severity. J Subst Abuse Treat. 2006 Jul;31(1):95-105. — View Citation

Timko C, Lesar M, Calvi NJ, Moos RH. Trends in acute mental health care: comparing psychiatric and substance abuse treatment programs. J Behav Health Serv Res. 2003 Apr-Jun;30(2):145-60. — View Citation

Timko C, Lesar M, Engelbrekt M, Moos RH. Changes in services and structure in community residential treatment facilities for substance abuse patients. Psychiatr Serv. 2000 Apr;51(4):494-8. — View Citation

Timko C, Sempel JM, Moos RH. Models of standard and intensive outpatient care in substance abuse and psychiatric treatment. Adm Policy Ment Health. 2003 May;30(5):417-36. — View Citation

Timko C, Sempel JM. Intensity of acute services, self-help attendance and one-year outcomes among dual diagnosis patients. J Stud Alcohol. 2004 Mar;65(2):274-82. — View Citation

Timko C, Sempel JM. Short-term outcomes of matching dual diagnosis patients' symptom severity to treatment intensity. J Subst Abuse Treat. 2004 Apr;26(3):209-18. — View Citation

Timko C, Yu K, Moos RH. Demand characteristics of residential substance abuse treatment programs. J Subst Abuse. 2000;12(4):387-403. — View Citation