One-year outcomes of telephone case monitoring for patients with substance use disorder

McKellar, John; Harris, Alexander H.S.; Oehlert, Mary E.; Buckley, Sara; Moos, Rudolf H.

doi:10.1016/j.addbeh.2012.03.009

Cited by 15 publications

(20 citation statements)

References 19 publications

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“…Finally, states could explore options for continuity services that rely on technology such as telehealth, which is relatively easy to deliver, extends the duration of treatment, and may produce longer lasting benefits . Patients receiving telephone case monitoring were found to achieve better short‐term outcomes on measures such as substance use and psychiatric symptoms . In their 2018 updates to the specifications for the performance measure Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment, the National Committee on Quality Assessment (NCQA) added telehealth to treatment options to reflect the latest guidelines for treatment…”

Section: Discussionmentioning

confidence: 99%

Rural Clients’ Continuity Into Follow‐Up Substance Use Disorder Treatment: Impacts of Travel Time, Incentives, and Alerts

Garnick

Horgan

Acevedo

et al. 2019

The Journal of Rural Health

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Purpose Treatment after discharge from detoxification or residential treatment is associated with improved outcomes. We examined the influence of travel time on continuity into follow‐up treatment and whether financial incentives and weekly alerts have a modifying effect. Methods For a research intervention during October 2013 to December 2015, detoxification and residential substance use disorder treatment programs in Washington State were randomized into 4 groups: potential financial incentives for meeting performance goals, weekly alerts to providers, both interventions, and control. Travel time was used as both a main effect and interacted with other variables to explore its modifying impact on continuity of care in conjunction with incentives or alerts. Continuity was defined as follow‐up care occurring within 14 days of discharge from detoxification or residential treatment programs. Travel time was estimated as driving time from clients’ home ZIP Code to treatment agency ZIP Code. Findings Travel times to the original treatment agency were in some cases significant with longer travel times predicting lower likelihood of continuity. For detoxification clients, those with longer travel times (over 91 minutes from their residence) are more likely to have timely continuity. Conversely, residential clients with travel times of more than 1 hour are less likely to have timely continuity. Interventions such as alerts or incentives for performance had some mitigating effects on these results. Travel times to the closest agency for potential further treatment were not significant. Conclusions Among rural clients discharged from detoxification and residential treatment, travel time can be an important factor in predicting timely continuity.

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Section: Discussionmentioning

confidence: 99%

Rural Clients’ Continuity Into Follow‐Up Substance Use Disorder Treatment: Impacts of Travel Time, Incentives, and Alerts

Garnick

Horgan

Acevedo

et al. 2019

The Journal of Rural Health

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“…During each telephone session, which also followed procedures in McKay and colleagues’ (2010a) manual, patients answered a Risk Assessment Worksheet (McKellar et al, 2012) covering behaviors since the previous call, i.e., substance use, psychiatric symptoms, compliance with substance use and mental health treatment (including medications), and participation in 12-step groups. Telephone Monitors positively reinforced any steps toward recovery, and reacted in a non-judgmental fashion to setbacks such as relapsing to substance use.…”

Section: Methodsmentioning

confidence: 99%

“…After in-person training sessions with clinical experts in motivational interviewing with the study’s patient population, a start-up practice phase was conducted during which Telephone Monitors were certified after delivering the intervention to enrolled patients who were considered training cases and not included in analyses. Telephone Monitors received regular supervision from a doctoral-level, licensed clinician that included review of session content and feedback on adherence to the manual, using a protocol checklist (McKellar et al, 2012). …”

Section: Methodsmentioning

confidence: 99%

“…An analysis of a telephone monitoring intervention for adults with cocaine dependence found it to be a cost-effective and potentially cost saving strategy for reducing substance use (McCollister et al, 2016). In contrast to robust findings of the McKay studies, a randomized controlled trial that assigned intensive substance use disorder outpatients to six months of telephone monitoring or usual care found that telephone-monitored patients achieved better substance use and psychiatric outcomes at 3-month, but not at 12-month, follow-up (McKellar et al 2012). …”

Section: Introductionmentioning

confidence: 91%

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Randomized controlled trial of telephone monitoring with psychiatry inpatients with co-occurring substance use and mental health disorders

Timko

Harris

Jannausch

et al. 2019

Drug and Alcohol Dependence

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Background: Psychiatry inpatients frequently have co-occurring substance use and mental health disorders, which are related to poor post-discharge outcomes. Telephone monitoring is effective in specialty substance use disorder treatment settings in increasing continuing care and 12-step program utilization and improving substance use outcomes. This study examined the effectiveness of telephone monitoring among psychiatry inpatients with co-occurring substance use and mental health disorders. Methods: This randomized controlled trial (n=406) compared usual care to usual care plus telephone monitoring (one in-person session during the inpatient stay, followed by weekly telephone contact for three months post-discharge). Follow-ups were conducted at end-of-intervention (3 months post-baseline) and 9 and 15 months post-baseline (73% followed). Primary outcomes were number of days, out of the past 30, of drinking alcohol, using drugs, and experiencing psychological problems. Secondary outcomes were outpatient substance use treatment, and 12-step group, utilization. Results: Longitudinal modeling found that patients in both conditions improved over time on each primary outcome. Improvement was comparable between conditions on alcohol and drug use and psychological problems. Receipt of outpatient treatment decreased over the follow-up period and was not related to condition. Likelihood of attending 12-step group meetings did not change over follow-ups, and was not related to condition. Conclusions: Among these patients, improvement over time was evident regardless of condition assignment. Patients maintained attendance at 12-step groups from pre- to post-discharge. Short-term telephone monitoring in addition to usual care for patients with co-occurring substance use and mental health disorders may not be sufficiently intensive to achieve additional improvements on outcomes.

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“…In fact, several studies have tested the effect of adding routine telephone-based follow-up contacts to standard continuing care practices among substance-dependent patients (e.g., [89–93]), and the general consensus is that this strategy is associated with improved clinical outcomes. For instance, McKay et al [91] tested the effect of adding up to 18 months of telephone continuing care to intensive-outpatient treatment on outcomes among a sample of alcohol-dependent patients following three weeks of intensive-outpatient treatment.…”

Section: Continuing Care Model Of Substance Use Treatmentmentioning

confidence: 99%

The Continuing Care Model of Substance Use Treatment: What Works, and When Is “Enough,” “Enough?”

Proctor

Herschman

2014

Psychiatry Journal

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There is little disagreement in the substance use treatment literature regarding the conceptualization of substance dependence as a cyclic, chronic condition consisting of alternating episodes of treatment and subsequent relapse. Likewise, substance use treatment efforts are increasingly being contextualized within a similar disease management framework, much like that of other chronic medical conditions (diabetes, hypertension, etc.). As such, substance use treatment has generally been viewed as a process comprised of two phases. Theoretically, the incorporation of some form of lower intensity continuing care services delivered in the context of outpatient treatment after the primary treatment phase (e.g., residential) appears to be a likely requisite if all stakeholders aspire to successful long-term clinical outcomes. Thus, the overarching objective of any continuing care model should be to sustain treatment gains attained in the primary phase in an effort to ultimately prevent relapse. Given the extant treatment literature clearly supports the contention that treatment is superior to no treatment, and longer lengths of stay is associated with a variety of positive outcomes, the more prudent question appears to be not whether treatment works, but rather what are the specific programmatic elements (e.g., duration, intensity) that comprise an adequate continuing care model. Generally speaking, it appears that the duration of continuing care should extend for a minimum of 3 to 6 months. However, continuing care over a protracted period of up to 12 months appears to be essential if a reasonable expectation of robust recovery is desired. Limitations of prior work and implications for routine clinical practice are also discussed.

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One-year outcomes of telephone case monitoring for patients with substance use disorder

Cited by 15 publications

References 19 publications

Rural Clients’ Continuity Into Follow‐Up Substance Use Disorder Treatment: Impacts of Travel Time, Incentives, and Alerts

Rural Clients’ Continuity Into Follow‐Up Substance Use Disorder Treatment: Impacts of Travel Time, Incentives, and Alerts

Randomized controlled trial of telephone monitoring with psychiatry inpatients with co-occurring substance use and mental health disorders

The Continuing Care Model of Substance Use Treatment: What Works, and When Is “Enough,” “Enough?”

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