Effectiveness of a Stand-alone Telephone-Delivered Intervention for Reducing Problem Alcohol Use

Lubman, Dan I.; Grigg, Jasmin; Reynolds, John; Hall, Kate; Baker, Amanda; Staiger, Petra K.; Tyler, Jonathan; Volpe, Isabelle; Stragalinos, Peta; Harris, Anthony; Best, David; Manning, Victoria

doi:10.1001/jamapsychiatry.2022.2779

Cited by 6 publications

(5 citation statements)

References 65 publications

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“…Workbooks containing exercises using node-link mapping are mailed to the caller and completed between sessions as an ongoing self-help resource (Lubman et al , 2019). A recent RCT ( n = 344) in a general population sample with problem alcohol use and related psychological distress (Lubman et al , 2022) found two or more sessions of the R2C programme significantly reduced hazardous alcohol use, alcohol problem severity, risky drinking patterns and total consumption, compared to a control group provided with basic health information and weekly check-in calls. Preliminary evidence suggests R2C may also be effective in reducing psychological distress and other drug problems (Grigg et al , 2021).…”

Section: Resultsmentioning

confidence: 99%

“…The limitations of intervention studies to date include limited sample sizes ( n = 398 in largest study) in specific populations. Although larger studies, such as RCTs of QuikFix (Hides et al , 2021) and R2C (Lubman et al , 2022), demonstrated the intervention to be effective in RCT settings, there have been few implementation studies to date to support efficacy in real-world populations (Grigg et al , 2021).…”

Section: Resultsmentioning

confidence: 99%

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Integrated care – panacea or white elephant? A review of integrated care approaches in Australia over the past two decades

Cheetham

Arunogiri

Lubman

2023

ADD

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Purpose Integrated care is widely supported as a means of improving treatment outcomes for people with co-occurring mental health and substance use disorders. Over the past two decades, Australian state and federal governments have identified integrated care as a policy priority and invested in a number of research and capacity building initiatives. This study aims to examine Australian research evaluating the effectiveness of integrated treatment approaches to provide insight into implications for future research and practice in integrated treatment. Design/methodology/approach This narrative review examines Australian research evaluating empirical evidence of the effectiveness of integrated treatment approaches within specific populations and evidence from initiatives aimed at integrating care at the service or system level. Findings Research conducted within the Australian context provides considerable evidence to support the effectiveness of integrated approaches to treatment, particularly for people with high prevalence co-occurring disorders or symptoms of these (i.e. anxiety and depression). These have been delivered through various modalities (including online and telephone-based services) to improve health outcomes in a range of populations. However, there is less evidence regarding the effectiveness of specific models or systems of integrated care, including for more severe mental disorders. Despite ongoing efforts on behalf of the Australian government, attempts to sustain system-level initiatives have remained hampered by structural barriers. Originality/value Effective integrated interventions can be delivered by trained clinicians without requiring integration at an organisational or structural level. While there is still considerable work to be done in terms of building sustainable models at a system level, this evidence provides a potential foundation for the development of integrated care models that can be delivered as part of routine practice.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Integrated care – panacea or white elephant? A review of integrated care approaches in Australia over the past two decades

Cheetham

Arunogiri

Lubman

2023

ADD

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“…Counselling approaches, such as motivational interviewing, capitalize on and enhance motivation to change [51]. These approaches can be highly effective for some people [52] but they can be less effective at creating the initial motivation to change [51,53]. Reappraisals start gradually and behavior changes irregularly, often in highly personalized ways [3,49].…”

Section: Cognitive Pathways: Recognizing Adverse Consequencesmentioning

confidence: 99%

Pathways to the persistence of drug use despite its adverse consequences

McNally

Jean-Richard-dit-Bressel

Millan

et al. 2023

Mol Psychiatry

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The persistence of drug taking despite its adverse consequences plays a central role in the presentation, diagnosis, and impacts of addiction. Eventual recognition and appraisal of these adverse consequences is central to decisions to reduce or cease use. However, the most appropriate ways of conceptualizing persistence in the face of adverse consequences remain unclear. Here we review evidence that there are at least three pathways to persistent use despite the negative consequences of that use. A cognitive pathway for recognition of adverse consequences, a motivational pathway for valuation of these consequences, and a behavioral pathway for responding to these adverse consequences. These pathways are dynamic, not linear, with multiple possible trajectories between them, and each is sufficient to produce persistence. We describe these pathways, their characteristics, brain cellular and circuit substrates, and we highlight their relevance to different pathways to self- and treatment-guided behavior change.

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“…Turning Point operates multiple helplines across several jurisdictions (> 100,000 contacts per annum), as well as two national online counselling services (> 1 million page views per annum). Turning Point (in collaboration with Monash and Deakin Universities) supported the development of the R2C program, and has tested its bene ts among individuals with alcohol, methamphetamine and cannabis use problems by way of two non-controlled studies (20,24), and a controlled trial of effectiveness among people with alcohol use disorder (42,43).…”

Section: Study Settingmentioning

confidence: 99%

“…A "per-protocol" sensitivity analysis will be restricted to those subjects with at least one follow-up assessment and, for subjects randomised to the R2C-M arm, participation in at least two telephone counselling sessions. Previous research delivering the R2C program to people with alcohol use disorder found exposure of ≥ 2 sessions yielded a reduction in alcohol use severity compared to a control arm (43). The rst R2C session focuses on a clinical assessment and identifying treatment goals and the second session is when a therapeutic dose is received.…”

Section: Statistical Analysis Planmentioning

confidence: 99%

A structured, telephone-delivered intervention to reduce methamphetamine use: Study protocol for a parallel group randomised controlled trial

Lubman

Manning

Arunogiri

et al. 2023

Preprint

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Background Australia has one of the highest rates of methamphetamine (MA) use in the world; however, uptake of in-person psychological treatment remains extremely low due to numerous individual (e.g., stigma, shame) and structural (e.g., service accessibility, geographical location) barriers to accessing care. Telephone-delivered interventions are ideally placed to overcome many of the known barriers to treatment access and delivery. This randomised controlled trial (RCT) will examine the efficacy of a standalone, structured telephone-delivered intervention to reduce MA problem severity and related harms. Methods This study is a double-blind, parallel group RCT. We will recruit 196 ± 8 individuals with mild to moderate MA use disorder from across Australia. After eligibility and baseline assessments, participants will be randomly allocated to receive either the Ready2Change-Methamphetamine (R2C-M) intervention (n = 98 ± 4; four to six telephone-delivered intervention sessions, R2C-M workbooks, and MA information booklet) or control (n = 98 ± 4; four to six ≤ 5-minute telephone check-ins and MA information booklet including information on accessing further support). Telephone follow-up assessments will occur at 6-weeks and 3-, 6- and 12-months post-randomisation. The primary outcome is change in MA problem severity (Drug Use Disorders Identification Test, DUDIT) at 3 months post-randomisation. Secondary outcomes are: MA problem severity (DUDIT) at 6- and 12-months post-randomisation; amount of methamphetamine used, methamphetamine use days, methamphetamine use disorder criteria met, cravings, psychological functioning, psychotic-like experiences, quality of life, and other drug use days (at some or all timepoints of 6-weeks and 3-, 6- and 12-month post-randomisation). Mixed-methods program evaluation will be performed and cost effectiveness will be examined. Discussion This study will be the first RCT internationally to assess the efficacy of a telephone-delivered intervention for MA use disorder and related harms. The proposed intervention is expected to provide an effective, low-cost, scalable treatment for individuals otherwise unlikely to seek care, preventing future harms and reducing health service and community costs. Trial registration: ClinicalTrials.gov NCT04713124, pre-registered 19 January, 2021. Protocol version V5 01 September 2022

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Effectiveness of a Stand-alone Telephone-Delivered Intervention for Reducing Problem Alcohol Use

Cited by 6 publications

References 65 publications

Integrated care – panacea or white elephant? A review of integrated care approaches in Australia over the past two decades

Integrated care – panacea or white elephant? A review of integrated care approaches in Australia over the past two decades

Pathways to the persistence of drug use despite its adverse consequences

A structured, telephone-delivered intervention to reduce methamphetamine use: Study protocol for a parallel group randomised controlled trial

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