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Using recovery management checkups for primary care to improve linkage to alcohol and other drug use treatment: a randomized controlled trial three month findings
Author(s) -
Scott Christy K,
Dennis Michael L.,
Grella Christine E.,
Watson Dennis P.,
Davis Jordan P.,
Hart M. Kate
Publication year - 2023
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.16064
Subject(s) - medicine , brief intervention , abstinence , randomized controlled trial , odds ratio , primary care , referral , alcohol use disorder , emergency medicine , alcohol , family medicine , psychiatry , biochemistry , chemistry
Background and Aims Recovery management checkups (RMC) have established efficacy for linking patients to substance use disorder (SUD) treatment. This study tested whether using RMC in combination with screening, brief intervention, and referral to treatment (SBIRT), versus SBIRT alone, can improve linkage of primary care patients referred to SUD treatment. Design A randomized controlled trial of SBIRT as usual ( n = 132) versus SBIRT plus recovery management checkups for primary care (RMC‐PC) ( n = 134) with follow‐up assessments at 3 months post‐baseline. Setting Four federally qualified health centers in the United States serving low‐income populations. Participants Primary care patients ( n = 266, 64% male, 80% Black, mean age, 48.3 [range, 19–53]) who were referred to SUD treatment after SBIRT. Interventions SBIRT alone (control condition) compared with SBIRT + RMC‐PC (experimental condition). Measurement The primary outcome was any days of SUD treatment in the past 3 months. Key secondary outcomes were days of SUD treatment overall and by level of care, days of alcohol and other drug (AOD) abstinence, and days of using specific substances, all based on self‐report. Findings At 3‐month follow‐up, those assigned to SBIRT + RMC‐PC ( n = 134) had higher odds of receiving any SUD treatment (46% vs 20%; adjusted odds ratio = 4.50 [2.49, 8.48]) compared with SBIRT only, including higher rates of entering residential and intensive outpatient treatment. They also reported more days of treatment (14.45, vs 7.13; d = +0.26), more days abstinent (41.3 vs 31.9; d = +0.22), and fewer days of using alcohol (27.14, vs 36.31; d = −0.25) and cannabis (19.49, vs 28.6; d = −0.20). Conclusions Recovery management checkups in combination with screening, brief intervention, and referral to treatment are an effective strategy for improving linkage of primary care patients in need to substance use disorder treatment over 3 months.