The use of patient navigation to transition detoxification patients to substance use treatment in the Alaska Interior
Objectives: Detoxification clinics manage acute intoxication and withdrawal from alcohol and other drugs. At discharge, patients are referred to treatment, yet many are readmitted to detoxification, creating a “revolving door” of discharges and admissions. This pattern disproportionately affects som...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | Public Health in Practice |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666535223000642 |
| _version_ | 1797398513526505472 |
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| author | Ursula Running Bear Erin M. Poole Clemma Muller Jessica D. Hanson Carolyn Noonan Jodi Trojan Robert Rosenman Spero M. Manson |
| author_facet | Ursula Running Bear Erin M. Poole Clemma Muller Jessica D. Hanson Carolyn Noonan Jodi Trojan Robert Rosenman Spero M. Manson |
| author_sort | Ursula Running Bear |
| collection | DOAJ |
| description | Objectives: Detoxification clinics manage acute intoxication and withdrawal from alcohol and other drugs. At discharge, patients are referred to treatment, yet many are readmitted to detoxification, creating a “revolving door” of discharges and admissions. This pattern disproportionately affects some groups such as Alaska Native and American Indian (AN/AI) people. The primary goals of this study are to: 1) test the effectiveness of a patient navigation intervention to increase rates of transition to alcohol treatment following detoxification, and 2) prevent readmission to detoxification within 12-months. The secondary goal is a cost-effectiveness and cost-benefit evaluation of patient navigation. Study design: This randomized controlled comparative effectiveness trial plans to recruit 440 patients (∼70% AN/AI) admitted to alcohol detoxification. We collaborated with Fairbanks Native Association (FNA) to select an appropriate intervention, control condition, and other study-related decisions. Here, we describe intervention development, study design, challenges encountered during implementation, and collaborative processes to identify solutions. Methods: Participants are equally randomized to the control (one motivational interviewing session) or intervention (one motivational interviewing session plus up to four weeks of patient navigation). The primary outcomes are successful transition to alcohol treatment within 30-days after discharge and detoxification readmission within 12-months. The secondary outcome is health-related quality of life. Conclusion: Patient navigation is successful in other settings and for other health conditions. It may assist in overcoming barriers to successful transition to substance use treatment and may augment interventions, such as motivational interviewing, that are less resource-intensive but may not be optimally effective by themselves. ClinicalTrials.gov Identifier: NCT03737864. |
| first_indexed | 2024-03-09T01:26:36Z |
| format | Article |
| id | doaj.art-ac3ef9f0f36248bebe255c8db64dcdf4 |
| institution | Directory Open Access Journal |
| issn | 2666-5352 |
| language | English |
| last_indexed | 2024-03-09T01:26:36Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Public Health in Practice |
| spelling | doaj.art-ac3ef9f0f36248bebe255c8db64dcdf42023-12-10T06:18:24ZengElsevierPublic Health in Practice2666-53522023-12-016100418The use of patient navigation to transition detoxification patients to substance use treatment in the Alaska InteriorUrsula Running Bear0Erin M. Poole1Clemma Muller2Jessica D. Hanson3Carolyn Noonan4Jodi Trojan5Robert Rosenman6Spero M. Manson7Department of Population Health, School of Medicine and Health Sciences, University of North Dakota, 1301 North Columbia Rd., Grand Forks, ND, USA; Corresponding author.University of Colorado Anschutz Medical Campus, Colorado School of Public Health, Centers for American Indian and Alaska Native Health, Aurora, CO, USAInitiative for Research and Education to Advance Community Health, Washington State University, Seattle, WA, USADepartment of Applied Human Sciences, University of Minnesota Duluth, Duluth, MN, USAInitiative for Research and Education to Advance Community Health, Washington State University, Seattle, WA, USASideTracks LLC, Fairbanks, AK, USAInitiative for Research and Education to Advance Community Health, Washington State University, Seattle, WA, USA; School of Economic Sciences, Washington State University, Pullman, WA, USAUniversity of Colorado Anschutz Medical Campus, Colorado School of Public Health, Centers for American Indian and Alaska Native Health, Aurora, CO, USAObjectives: Detoxification clinics manage acute intoxication and withdrawal from alcohol and other drugs. At discharge, patients are referred to treatment, yet many are readmitted to detoxification, creating a “revolving door” of discharges and admissions. This pattern disproportionately affects some groups such as Alaska Native and American Indian (AN/AI) people. The primary goals of this study are to: 1) test the effectiveness of a patient navigation intervention to increase rates of transition to alcohol treatment following detoxification, and 2) prevent readmission to detoxification within 12-months. The secondary goal is a cost-effectiveness and cost-benefit evaluation of patient navigation. Study design: This randomized controlled comparative effectiveness trial plans to recruit 440 patients (∼70% AN/AI) admitted to alcohol detoxification. We collaborated with Fairbanks Native Association (FNA) to select an appropriate intervention, control condition, and other study-related decisions. Here, we describe intervention development, study design, challenges encountered during implementation, and collaborative processes to identify solutions. Methods: Participants are equally randomized to the control (one motivational interviewing session) or intervention (one motivational interviewing session plus up to four weeks of patient navigation). The primary outcomes are successful transition to alcohol treatment within 30-days after discharge and detoxification readmission within 12-months. The secondary outcome is health-related quality of life. Conclusion: Patient navigation is successful in other settings and for other health conditions. It may assist in overcoming barriers to successful transition to substance use treatment and may augment interventions, such as motivational interviewing, that are less resource-intensive but may not be optimally effective by themselves. ClinicalTrials.gov Identifier: NCT03737864.http://www.sciencedirect.com/science/article/pii/S2666535223000642DetoxificationAlcoholOpioidSubstance use treatmentPatient navigationAlaska Native |
| spellingShingle | Ursula Running Bear Erin M. Poole Clemma Muller Jessica D. Hanson Carolyn Noonan Jodi Trojan Robert Rosenman Spero M. Manson The use of patient navigation to transition detoxification patients to substance use treatment in the Alaska Interior Public Health in Practice Detoxification Alcohol Opioid Substance use treatment Patient navigation Alaska Native |
| title | The use of patient navigation to transition detoxification patients to substance use treatment in the Alaska Interior |
| title_full | The use of patient navigation to transition detoxification patients to substance use treatment in the Alaska Interior |
| title_fullStr | The use of patient navigation to transition detoxification patients to substance use treatment in the Alaska Interior |
| title_full_unstemmed | The use of patient navigation to transition detoxification patients to substance use treatment in the Alaska Interior |
| title_short | The use of patient navigation to transition detoxification patients to substance use treatment in the Alaska Interior |
| title_sort | use of patient navigation to transition detoxification patients to substance use treatment in the alaska interior |
| topic | Detoxification Alcohol Opioid Substance use treatment Patient navigation Alaska Native |
| url | http://www.sciencedirect.com/science/article/pii/S2666535223000642 |
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