A longitudinal evaluation of treatment engagement and recovery stages

Simpson, D. Dwayne; Joe, George W.

doi:10.1016/j.jsat.2004.03.001

Cited by 153 publications

(141 citation statements)

References 48 publications

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“…26,27 Based only on speculation, individuals on combination therapy for smoking cessation may have higher self-efficacy and motivation to quit, which in turn may be reflected in improved adherence. 28 Finally, a substantial limitation is that administrative claims data do not allow for valid and reliable assessment of clinical outcomes associated with smoking cessation treatment (i.e., tobacco abstinence). The relationship between varenicline OOP costs and medication adherence measured by PDC was modest, and the relationship between days' coverage with medication and tobacco cessation in the real-world setting has not been established.…”

Section: ■■ Conclusionmentioning

confidence: 99%

Association of Out-of-Pocket Pharmacy Costs with Adherence to Varenicline

Suehs¹,

Davis²,

Galaznik³

et al. 2014

JMCP

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BACKGROUND: Varenicline, a nicotinic acetylcholine receptor partial agonist, is a pharmacotherapy indicated for smoking cessation treatment. To date, no research has examined the relationship between out-of-pocket (OOP) expense and varenicline adherence among Medicare beneficiaries.OBJECTIVES: To (a) characterize medication utilization patterns of varenicline among Medicare members newly initiated on varenicline and (b) examine the relationship between member OOP expense and varenicline medication adherence.METHODS: In this retrospective cohort study, pharmacy claims data were used to identify Medicare Advantage Prescription Drug Plan (MAPD) members newly initiated on varenicline. Demographic and clinical characteristics, varenicline medication utilization patterns, and pharmacy costs (total and varenicline-specific) were determined for members included in the study. Varenicline adherence was measured by calculating the proportion of days covered (PDC) over a period of 84 days (12 weeks) after initiation. Multiple regression analysis was used to examine the relationship between varenicline OOP cost and varenicline medication utilization, while controlling for sociodemographic characteristics, clinical factors, and nonvarenicline pharmacy costs.RESULTS: A total of 15,452 MAPD members were included in the analysis. Mean (SD) subject age was 62.6 (10.0) years; 21.1% (n = 3,256) were dual eligible; and 33.0% (n = 5,106) received a low-income subsidy. Mean (SD) initial varenicline treatment episode duration was 50.8 (37.8) days, with a mean (SD) varenicline days' supply of 47.8 (32.6) obtained by members during the initial treatment episode. Mean (SD) PDC was 0.51 (0.24), and 14.9% (n = 2,302) of members were classified as adherent to treatment (PDC ≥ 0.80). Greater varenicline OOP expense was significantly associated with lower PDC (regression coefficient = -0.058, P < 0.001) and significantly associated with lower odds of receiving a refill for varenicline (odds ratio 0.594, 95% CI: 0.540-0.655, P < 0.001).CONCLUSIONS: Among Medicare beneficiaries newly initiated on varenicline, medication adherence was suboptimal, and greater OOP cost was associated with lower adherence and lower odds of refilling varenicline.

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Section: ■■ Conclusionmentioning

confidence: 99%

Association of Out-of-Pocket Pharmacy Costs with Adherence to Varenicline

Suehs¹,

Davis²,

Galaznik³

et al. 2014

JMCP

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“…Counselors are key players in both the delivery of treatment, especially in regard to their ability to affect client engagement (e.g., Barber et al, 2001;Joe, Simpson, Dansereau, & Rowan-Szal, 2001;Martin, Garske, & Davis, 2000;Simpson & Joe, 2004), and the transfer process of evidence-based interventions into clinical practice (e.g., Knudsen & Roman, 2004;Knudsen, Ducharme, Roman, & Link, 2005). Indeed, their views of the treatment program as a workplace and its social norms also are associated with the treatment experiences and progress of their clients (e.g., Broome et al, this issue;Moos & Moos, 1998), as well as their own job engagement and satisfaction (e.g., Maslach, Shaufeli, & Leiter, 2001).…”

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confidence: 99%

Counselor perceptions of organizational factors and innovations training experiences

Joe

Broome

Simpson

et al. 2007

Journal of Substance Abuse Treatment

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Because work environment is central to understanding job performance, drug counselor perceptions of their programs and their skills were examined in relation to their attitudes about innovations training and its utilization. Latent profile analysis of measures on organizational climate and staff attributes for 1047 counselors from 345 programs defined three categories of counselors -labeled as Isolated, Integrated, and Exceptional. All had generally positive views of their professional skills, although the Isolated group scored lower on scales representing professional growth and influence on peers. They were less positive about the "climate" of programs in which they worked and were higher on stress. Program resources predicted the counselor groups, with the Isolated having more limited resources. Counselor categorizations also differed in terms of workshop training experiences, with the Isolated group of counselors reporting significantly less exposure, satisfaction, and program-wide use of workshop training.

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“…A few other variables that discriminated had smaller impact than these two treatment process measures. The utility of the recovery patterns in the current research suggest that the area of expectations might be viable as an indicator of treatment progress in addition to that of counseling rapport, whose usefulness has been demonstrated in modeling treatment process (e.g., Simpson & Joe, 2004) and in predicting follow-up outcomes (e.g., Joe et al, 2001). Even though rapport was a strong discriminator of the groups, expectations might be a useful separate indicator of treatment progress.…”

Section: Discussionmentioning

confidence: 74%

Patterns of drug use and expectations in methadone patients

Joe

Flynn

Broome

et al. 2007

Addictive Behaviors

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Expectations about future behavior have been shown to have a positive relationship with subsequent behavior. For patients in drug treatment, recovery should manifest changes in drug use and in cognitive perceptions of being able to refrain from use. The present study identified latent patterns of the longitudinal relationship between drug use expectation and illegal drug use during treatment. Latent variable mixture modeling identified three patterns of change over successive 3-month intervals during treatment: Improvers (48%), Decliners (33%), and Continuing Users (19%). The sample consisted of 497 patients in community-based outpatient methadone treatment. The utility of the latent patterns was shown through their relationship to treatment engagement, where Continuing Users had lower counseling rapport and time in treatment. These latent patterns also differed on drug use measures at follow-up. Additional analyses of expectations with measures of opioid use, cocaine use, or criminality yielded similar latent patterns. Expectations about future drug use were found to be a useful measure of cognitive change corresponding to drug use change. Its potential as a brief treatment management tool is noted.

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A longitudinal evaluation of treatment engagement and recovery stages

Cited by 153 publications

References 48 publications

Association of Out-of-Pocket Pharmacy Costs with Adherence to Varenicline

Association of Out-of-Pocket Pharmacy Costs with Adherence to Varenicline

Counselor perceptions of organizational factors and innovations training experiences

Patterns of drug use and expectations in methadone patients

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