Case management for persons with substance use disorders

Hesse, Morten; Vanderplasschen, Wouter; Rapp, Richard C.; Broekaert, Eric; Fridell, Mats

doi:10.1002/14651858.cd006265.pub2

Cited by 62 publications

(76 citation statements)

References 78 publications

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“…Case management is an effective strategy for HIV infected IDU patients to improve substance abuse and HIV treatment outcomes [20,21]. HIV-infected individuals with case managers are more likely to receive benefits advocacy, psychological services, and emotional and practical support.…”

Section: Introductionmentioning

confidence: 99%

The feasibility of an intensive case management program for injection drug users on antiretroviral therapy in St. Petersburg, Russia

Шаболтас

Skochilov

Brown

et al. 2013

Harm Reduction Journal

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BackgroundThe majority of HIV-infected individuals requiring antiretroviral therapy (ART) in Russia are Injection Drug Users (IDU). Substitution therapy used as part of a comprehensive harm reduction program is unavailable in Russia. Past data shows that only 16% of IDU receiving substance abuse treatment completed the course without relapse, and only 40% of IDU on ART remained on treatment at 6 months. Our goal was to determine if it was feasible to improve these historic outcomes by adding intensive case management (ICM) to the substance abuse and ART treatment programs for IDU.MethodsIDU starting ART and able to involve a “supporter” who would assist in their treatment plan were enrolled. ICM included opiate detoxification, bi-monthly contact and counseling with the case, weekly group sessions, monthly contact with the “supporter” and home visits as needed. Full follow- up (FFU) was 8 months. Stata v10 (College Station, TX) was used for all analysis. Descriptive statistics were calculated for all baseline demographic variables, baseline and follow-up CD4 count, and viral load. Median baseline and follow-up CD4 counts and RNA levels were compared using the Kruskal-Wallis test. The proportion of participants with RNA < 1000 copies mL at baseline and follow-up was compared using Fisher’s Exact test. McNemar’s test for paired proportions was used to compare the change in proportion of participants with RNA < 1000 copies mL from baseline to follow-up.ResultsBetween November 2007 and December 2008, 60 IDU were enrolled. 34 (56.7%) were male. 54/60 (90.0%) remained in FFU. Overall, 31/60 (52%) were active IDU at enrollment and 27 (45%) were active at their last follow-up visit. 40/60 (66.7%) attended all of their ART clinic visits, 13/60 (21.7%) missed one or more visit but remained on ART, and 7/60 (11.7%) stopped ART before the end of FFU. Overall, 39/53 (74%) had a final 6–8 month HIV RNA viral load (VL) < 1000 copies/mL.ConclusionsDespite no substitution therapy to assist IDU in substance abuse and ART treatment programs, ICM was feasible, and the retention and adherence of IDU on ART in St. Petersburg could be greatly enhanced by adding ICM to the existing treatment programs.

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Section: Introductionmentioning

confidence: 99%

The feasibility of an intensive case management program for injection drug users on antiretroviral therapy in St. Petersburg, Russia

Шаболтас

Skochilov

Brown

et al. 2013

Harm Reduction Journal

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“…Other approaches to consider are interventions to link people to treatment, such as case management strengths-based case management (Hesse, Vanderplasschen, Rapp, Broekaert, & Fridell, 2007; C. A. Rapp & Goscha, 2008; R.…”

Section: Discussionmentioning

confidence: 99%

Benefit-cost analysis of SBIRT interventions for substance using patients in emergency departments

Horn

Crandall

Forcehimes

et al. 2017

Journal of Substance Abuse Treatment

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Screening, brief intervention, and referral to treatment (SBIRT) has been widely implemented as a method to address substance use disorders in general medical settings, and some evidence suggests that its use is associated with decreased societal costs. In this paper, we investigated the economic impact of SBIRT using data from Screening, Motivational Assessment, Referral, and Treatment in Emergency Departments (SMART-ED), a multisite, randomized controlled trial. Utilizing self-reported information on medical status, health services utilization, employment, and crime, we conduct a benefit-cost analysis. Findings indicate that neither of the SMART-ED interventions resulted in any significant changes to the main economic outcomes, nor had any significant impact on total economic benefit. Thus, while SBIRT interventions for substance abuse in Emergency Departments may be appealing from a clinical perspective, evidence from this economic study suggests resources could be better utilized supporting other health interventions.

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“…l CBT -an approach aiming to manage cannabis use by changing the way the participant thinks or behaves 29 l MI -a person-centred approach that aims to improve motivation to change and resolve ambivalence to change 30 l MET -a variant of MI that is manual based 31 l relapse prevention therapy -based on CBT, enables clients to cope with high-risk situations that may lead to drug taking 32 l contingency management -providing patients with tangible rewards (such as monetary vouchers) in return for a reduction or cessation in drug taking 20 l case management -a strategy to improve the co-ordination and continuity of the delivery of services to a patient 33 l mutual aid therapy -therapy in which people with similar experiences assist each other to overcome or manage their issues (e.g. Self-Management and Recovery Training) l other psychological and psychosocial interventions as identified within the review process.…”

Section: Included Interventionsmentioning

confidence: 99%

“…The majority of previous reviews in this topic area have restricted their scope to a subtype of intervention or population, or are not specific to cannabis users. 6,33 The present review has included all psychosocial or psychological interventions undertaken in the adult, community-dwelling population of cannabis users and has only included RCTs, ensuring that only the highest quality available evidence has been included. Robust methods were used, including a search methodology with wide scope, grey literature searching and contact with clinical experts in the area.…”

Section: Strengthsmentioning

confidence: 99%

Psychological and psychosocial interventions for cannabis cessation in adults: a systematic review short report

Cooper

Chatters

Kaltenthaler

et al. 2015

Health Technol Assess

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BackgroundCannabis is the most commonly used illicit drug worldwide. Cannabis dependence is a recognised psychiatric diagnosis, often diagnosed via theDiagnostic and Statistical Manual of Mental Disorderscriteria and theInternational Classification of Diseases, 10th Revision. Cannabis use is associated with an increased risk of medical and psychological problems. This systematic review evaluates the use of a wide variety of psychological and psychosocial interventions, such as motivational interviewing (MI), cognitive–behavioural therapy (CBT) and contingency management.ObjectiveTo systematically review the clinical effectiveness of psychological and psychosocial interventions for cannabis cessation in adults who use cannabis regularly.Data sourcesStudies were identified via searches of 11 databases [MEDLINE, EMBASE, Cochrane Controlled Trials Register, Health Technology Assessment (HTA) database, Database of Abstracts of Reviews of Effects, Cochrane Database of Systematic Reviews, NHS Economic Evaluation Database, PsycINFO, Web of Science Conference Proceedings Citation Index, ClinicalTrials.gov andmetaRegister of Current Controlled Trials] from inception to February 2014, searching of existing reviews and reference tracking.MethodsRandomised controlled trials (RCTs) assessing psychological or psychosocial interventions in a community setting were eligible. Risk of bias was assessed using adapted Cochrane criteria and narrative synthesis was undertaken. Outcomes included change in cannabis use, severity of cannabis dependence, motivation to change and intervention adherence.ResultsThe review included 33 RCTs conducted in various countries (mostly the USA and Australia). General population studies: 26 studies assessed the general population of cannabis users. Across six studies, CBT (4–14 sessions) significantly improved outcomes (cannabis use, severity of dependence, cannabis problems) compared with wait list post treatment, maintained at 9 months in the one study with later follow-up. Studies of briefer MI or motivational enhancement therapy (MET) (one or two sessions) gave mixed results, with some improvements over wait list, while some comparisons were not significant. Four studies comparing CBT (6–14 sessions) with MI/MET (1–4 sessions) also gave mixed results: longer courses of CBT provided some improvements over MI. In one small study, supportive–expressive dynamic psychotherapy (16 sessions) gave significant improvements over one-session MI. Courses of other types of therapy (social support group, case management) gave similar improvements to CBT based on limited data. Limited data indicated that telephone- or internet-based interventions might be effective. Contingency management (vouchers for abstinence) gave promising results in the short term; however, at later follow-ups, vouchers in combination with CBT gave better results than vouchers or CBT alone. Psychiatric population studies: seven studies assessed psychiatric populations (schizophrenia, psychosis, bipolar disorder or major depression). CBT appeared to have little effect over treatment as usual (TAU) based on four small studies with design limitations (both groups received TAU and patients were referred). Other studies reported no significant difference between types of 10-session therapy.LimitationsIncluded studies were heterogeneous, covering a wide range of interventions, comparators, populations and outcomes. The majority were considered at high risk of bias. Effect sizes were reported in different formats across studies and outcomes.ConclusionsBased on the available evidence, courses of CBT and (to a lesser extent) one or two sessions of MI improved outcomes in a self-selected population of cannabis users. There was some evidence that contingency management enhanced long-term outcomes in combination with CBT. Results of CBT for cannabis cessation in psychiatric populations were less promising, but may have been affected by provision of TAU in both groups and the referred populations. Future research should focus on the number of CBT/MI sessions required and potential clinical effectiveness and cost-effectiveness of shorter interventions. CBT plus contingency management and mutual aid therapies warrant further study. Studies should consider potential effects of recruitment methods and include inactive control groups and long-term follow-up. TAU arms in psychiatric population studies should aim not to confound the study intervention.Study registrationThis study is registered as PROSPERO CRD42014008952.FundingThe National Institute for Health Research HTA programme.

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Case management for persons with substance use disorders

Abstract: Analysis 01.01. Comparison 01 Case Management versus treatment as usual., Outcome 01 Illicit drug use outcomes Analysis 01.02. Comparison 01 Case Management versus treatment as usual., Outcome 02 Alcohol use outcomes. Analysis 01.04. Comparison 01 Case Management versus treatment as usual.

Cited by 62 publications

References 78 publications

The feasibility of an intensive case management program for injection drug users on antiretroviral therapy in St. Petersburg, Russia

The feasibility of an intensive case management program for injection drug users on antiretroviral therapy in St. Petersburg, Russia

Benefit-cost analysis of SBIRT interventions for substance using patients in emergency departments

Psychological and psychosocial interventions for cannabis cessation in adults: a systematic review short report

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