Telephone-based continuing care counseling in substance abuse treatment: Economic analysis of a randomized trial

Abstract

Purpose To investigate whether telephone-based continuing care (TEL) is a promising alternative to traditional face-to-face counseling for clients in treatment for substance abuse. Methods Patients with alcohol and/or cocaine dependence who had completed a 4-week intensive outpatient program were randomly assigned through urn randomization into one of three 12-week interventions: standard continuing care (STD), in-person relapse prevention (RP), or telephone-based continuing care (TEL). This study performed cost, cost-effectiveness, and cost-benefit analyses of TEL and RP compared to STD, using results from the randomized clinical trial with two years of follow up (359 participants). In addition, the study examined the potential moderating effect of baseline patient costs on economic outcomes. Results The study found that TEL was less expensive per client from the societal perspective ($569) than STD ($870) or RP ($1,684). TEL also was also significantly more effective, with an abstinence rate of 57.1% compared to 46.7% for STD (p<0.05). Thus TEL dominated STD, with a highly favorable negative incremental cost-effectiveness ratio (−$1,400 per abstinent year). TEL also proved favorable under a benefit-cost perspective. Conclusions TEL proved to be a cost-effective and cost-beneficial contributor to long-term recovery over two years. Because TEL dominated STD care interventions, wider adoption should be considered.

Study protocol the Continuing Care Project: a randomised controlled trial of a continuing care telephone intervention following residential substance dependence treatment

“…For example, the study includes both males and females, participants with with co-occurring mental illness and has no exclusionary criteria based on primary substance. The proposed trial will extend on the existing research on the continuing care intervention [10][11][12] by recruiting a sample from residential treatment services rather than from outpatient services. Providing opportunity to examine whether the clinical and cost effectiveness of the intervention found in outpatient samples is applicable to those receiving inpatient treatment from residential settings.…”

“…Subsequent economic analysis of the telephone approach has found that it is cost effective to deliver [6,[10][11][12]. The protocol developed by McKay is listed on SAMHSA's National Registry of Evidence Based Programs and Practices (NREPP).…”

Economic impact of faith‐based residential addiction recovery for the homeless

“…Repeated psychiatric re‐hospitalizations and service usage were associated with comorbid psychiatric and substance use disorders; however, the researchers did not study the cost of this usage. Shepard et al (2016) examined the economic impact of a telephone‐based continuing care counseling intervention in substance abuse treatment. The researchers found that the intervention was less expensive per client than face‐to‐face counseling and produced a significantly higher abstinence rate among patients with alcohol and/or cocaine dependence who completed a month long intensive outpatient treatment program.…”

A SMART data analysis method for constructing adaptive treatment strategies for substance use disorders

“…Hence, while ATS #1 recommends that TDM should be added to all responders, the more tailored ATS (ATS #2) recommends TDM to only 33 % of responders. Although TDM is a cost-effective and potentially cost-saving strategy for treating SUDs compared to face-to-face alternatives [40], costs per session are estimated at $30.24 for the client and $30.55 for the health system [41]. Hence, employing the more tailored ATS (ATS #2) may result in substantially lower cost of treatment, while achieving outcomes similar to ATS #1.…”