There is increasing evidence that a chronic care model may be effective when treating substance use disorders. In 1996, the Betty Ford Center (BFC) began implementing a telephone-based continuing care intervention now called Focused Continuing Care (FCC) to assist and support patients in their transition from residential treatment to longer-term recovery in the "real world". This article reports on patient utilization and outcomes of FCC. FCC staff placed clinically directed telephone calls to patients (N=4094) throughout the first year after discharge. During each call, a short survey was administered to gauge patient recovery and guide the session. Patients completed an average of 5.5 (40%) of 14 scheduled calls, 58% completed 5 or more calls, and 85% were participating in FCC two months post-discharge or later. There was preliminary evidence that greater participation in FCC yielded more positive outcomes and that early post-discharge behaviors predict subsequent outcomes. FCC appears to be a feasible therapeutic option. Efforts to revise FCC to enhance its clinical and administrative value are described.
It is important to understand whether the number of prior treatment episodes relate to treatment completion, discharge status, and 6-month outcomes. The data set contains information on 2,429 clients in treatment. A modified Addiction Severity Index was administered at the time of admission and at 6-months postdischarge. Additionally, length of stay and discharge status data were obtained. ANOVAs, MANOVAs, and chi(2) tests were used. Clients with the most prior treatment episodes had greater baseline substance use and psychosocial severity, and were more likely to be treated in residential settings. Nonetheless, treatment acceptance was greatest for these clients. Clients with no prior treatment reported the least acceptance. Treatment completion rates did not vary as a function of treatment experience. Clients achieved positive changes in multiple life domains regardless of treatment history. Nevertheless, at admission, discharge and follow-up, clients with >or= 2 treatments generally had greater problems than clients with fewer treatments.
This study evaluated the predictive validity of two automated approaches based on the Addiction Severity Index (ASI) to patient placement criteria. Patients (N = 2,429) in 78 substance abuse treatment programs completed an ASI at intake and were assigned a treatment modality based on availability and clinical considerations. Treatment completion and self-reported abstinence 6 months post-discharge were collected. Two placement approaches were developed using ASI summary score cut points or problem-specific algorithms from ASI items. Both approaches showed evidence of predictive validity. Given the ASI's widespread use in community programs, evidence is provided in support of its ability to inform clinical judgment and implementation of standardized placement.
Background Scientific evidence exists on integration of pharmacists within the oncology team and their positive influence on patient care. Investigation into the effect of pharmacist involvement for oncology inpatients at Sir Paul Boffa Hospital, Malta, is required to initiate clinical pharmacy services. Purpose The study aimed to determine the effect of pharmacist involvement in the treatment of oncology inpatients at Sir Paul Boffa Hospital, Malta, in terms of clinical significance on patient care. Materials and methods Study design followed non-randomised purposive sampling including all patients at the two oncology inpatient wards at Sir Paul Boffa Hospital, Malta. Data was collected prospectively over a period of nine weeks through drug reviews and drug chart checking, using a modified French Society of Clinical Pharmacy documentation tool. A multidisciplinary panel independently and retrospectively assessed the pharmacist’s interventions in terms of clinical significance on patient care using a 4-point Likert scale. Group differences were analysed using the Kruskal-Wallis test at a 0.05 level of significance. Strengths of relationships were measured using Spearman’s correlation coefficient. Results For 72 patients reviewed, 80 drug-related problems (DRPs) and pharmacist interventions were documented. In line with published data for oncology settings, the majority of interventions were related to comorbidities and concomitant medications (63.8%). The most common DRPs (adverse drug reactions, untreated indications, subtherapeutic dosage, drug monitoring) and pharmacist interventions (dose adjustment, drug switch, addition of a new drug, drug discontinuation) identified were in agreement with studies for oncology inpatients conducted elsewhere. More than half of the pharmacist’s interventions were rated as having major or moderate clinical significance on patient care (68.8%). Conclusions Pharmacist involvement for oncology inpatients at Sir Paul Boffa Hospital, Malta, has improved patient care by enhancing patient safety and ensuring treatment optimisation. Thus, high-quality cancer services are provided when pharmacists are involved within a multidisciplinary team. No conflict of interest.
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