Integrated outpatients treatment for medically ill alcoholic men: results from a quasi-experimental study.

Willenbring, Mark L.; Olson, Douglas H.; Bielinski, John

doi:10.15288/jsa.1995.56.337

Cited by 21 publications

(28 citation statements)

References 15 publications

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“…19 Many people with alcohol dependence who suffer from secondary illnesses will not accept onward referrals to alcohol treatment programs. 20,21 Furthermore, healthcare professionals working in medical services may not be skilled at recognizing or treating alcohol misuse. 22 Therefore, it may be more appropriate for any intervention undertaken with this patient group to take place in the gastroenterology clinic itself, by trained specialist alcohol liaison workers.…”

Section: Discussionmentioning

confidence: 99%

Motivation to change drinking behavior: the differences between alcohol users from an outpatient gastroenterology clinic and a specialist alcohol treatment service

et al. 2005

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CONTEXT AND OBJECTIVE: For some patients who have developed significant alcohol-related physical disease, total abstinence from alcohol may offer the best chance of survival. The aim of this study was to investigate motivation for treatment in two groups of alcohol users: outpatients from the gastroenterology clinic and outpatients from the specialist alcohol treatment service. DESIGN AND SETTING: Cross-sectional study, at a federally funded public teaching hospital. METHODS: The sample studied was 151 outpatients from the gastroenterology clinic and 175 from the specialist alcohol treatment service. The interview was conducted in the outpatient clinics at the first appointment, and consisted of demographic questions and scales for measuring quality of life, alcohol dependence, pattern of alcohol, motivation for treatment and consequences of alcohol consumption. RESULTS: The results suggested that outpatients from the gastroenterology clinic were less dependent on alcohol, had suffered fewer consequences from alcohol and had fewer emotional and mental health problems than did the outpatients from the alcohol treatment service. In relation to their stages of change, the gastroenterology outpatients presented high precontemplation scores at the beginning of treatment while outpatients of alcohol treatment service showed higher scores in contemplation, action and maintenance. CONCLUSION: The medical treatment may be a reason for the temporary alcohol abstinence behavior among the gastroenterology outpatients.

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Section: Discussionmentioning

confidence: 99%

Motivation to change drinking behavior: the differences between alcohol users from an outpatient gastroenterology clinic and a specialist alcohol treatment service

et al. 2005

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“…There were no overall differences in abstinence, but in a subgroup of patients with substance abuse-related medical conditions (57%), on-site care was associated with increased abstinence at 6 months. In a randomized trial in a special alcohol clinic for veterans, 163 the integrated care group was more likely to be abstinent than a usual care group (74% versus 49% 30-day abstinence). 164 The study intervention was focused on alcoholism but included substantial attention to comorbidity.…”

Section: Elements Of Cdm For Addiction Proven Effectivementioning

confidence: 99%

The Case for Chronic Disease Management for Addiction

Saitz

Larson

LaBelle

et al. 2008

Journal of Addiction Medicine

124

102

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Chronic disease (care) management (CDM) is a patient-centered model of care that involves longitudinal care delivery; integrated, and coordinated primary medical and specialty care; patient and clinician education; explicit evidence-based care plans; and expert care availability. The model, incorporating mental health and specialty addiction care, holds promise for improving care for patients with substance dependence who often receive no care or fragmented ineffective care. We describe a CDM model for substance dependence and discuss a conceptual framework, the extensive current evidence for component elements, and a promising strategy to reorganize primary and specialty health care to facilitate access for people with substance dependence. The CDM model goes beyond integrated case management by a professional, colocation of services, and integrated medical and addiction care-elements that individually can improve outcomes. Supporting evidence is presented that: 1) substance dependence is a chronic disease requiring longitudinal care, although most patients with addictions receive no treatment (eg, detoxification only) or short-term interventions, and 2) for other chronic diseases requiring longitudinal care (eg, diabetes, congestive heart failure), CDM has been proven effective. Keywordschronic disease management; addiction; primary care; linkage; addiction treatment; chronic care model; recovery Substance (alcohol and drug) dependence is a chronic disease for which many affected adults receive no intervention or detoxification without subsequent treatment. Like other chronic diseases (eg, diabetes, congestive heart failure), substance dependence has no cure and is characterized by relapses requiring longitudinal care. Medical and psychiatric comorbidities are the rule rather than the exception. As a result, care delivery can be complex both for clinicians and patients. In the United States, systems of care for substance dependence (both alcohol and drug) are rarely integrated with those for medical and psychiatric illnesses. Specialty alcohol and drug treatment is efficacious, but many patients do not access available treatment for substance dependence problems after detoxification or medical care. Others enter NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript specialty addiction treatment but do not receive medical or psychiatric care. Some have called to expand the frame of health services research on addictions to include services outside the specialty treatment sector, including behavioral care integrated into primary care. [1][2][3] Although primary care settings provide the venue for longitudinal, comprehensive, and coordinated care, their potential to effectively treat addiction and related comorbidities has not been realized; medical, mental health, and addiction treatment are not coordinated. Primary care settings, with reorganization and appropriate service elements, hold the promise of simultaneously improving physical and psychiatric health while decreasing substan...

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“…In an outpatient medical clinic setting, integrated substance abuse and medical care was shown in both a quasi-experimental trial and a randomized controlled trial to significantly improve abstinence and engagement in treatment among participants. 21,22 Likewise, introducing primary care services into outpatient treatment settings has also been shown effective.…”

mentioning

confidence: 99%

Outpatient treatment entry and health care utilization after a combined medical/substance abuse intervention for hospitalized medical patients

et al. 2002

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Integrated outpatients treatment for medically ill alcoholic men: results from a quasi-experimental study.

Cited by 21 publications

References 15 publications

Motivation to change drinking behavior: the differences between alcohol users from an outpatient gastroenterology clinic and a specialist alcohol treatment service

Motivation to change drinking behavior: the differences between alcohol users from an outpatient gastroenterology clinic and a specialist alcohol treatment service

The Case for Chronic Disease Management for Addiction

Outpatient treatment entry and health care utilization after a combined medical/substance abuse intervention for hospitalized medical patients

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