The effect of telephonic patient support on treatment for opioid dependence: outcomes at one year follow-up.

OBJECTIVE: The present study examined the impact of a telephonic patient support program known as HereToHelp™ (HTH) on compliance and treatment outcomes among opioid dependent (OD) patients new to buprenorphine treatment (BUP). METHOD: A total of 1426 OD patients new to BUP were randomized to receive BUP alone (standard care) or BUP plus the HTH patient support program. All patients completed the Addiction Severity Index (ASI) at the time of enrollment, and at 12months post-enrollment. RESULTS: Subjects randomized to the HTH support program who accepted at least 3 care coach intervention calls were more compliant with BUP than the standard care group at month 12 (64.4% vs. 56.1%, χ(2)=5.09, p<.025). Compared to patients who were non-compliant with BUP, compliant patients reported significantly lower scores on all 7 of the ASI composite scores, indicating lower severity on addiction-related problems. CONCLUSIONS: The HTH intervention seemed to improve patient treatment outcomes indirectly by improving compliance with BUP. Supplementing BUP with a structured, telephonic compliance-enhancement program is an effective way to improve compliance with medication which then improves patient outcomes.

Telephonic screening and brief intervention for alcohol misuse among workers contacting the employee assistance program: A feasibility study.

INTRODUCTION AND AIMS: Substantial empirical support exists for alcohol screening, brief intervention, and referral to treatment (SBIRT) in medical, but not non-medical settings such as the workplace. Workplace settings remain underutilised for delivering evidenced-based health services. This research aims to translate medical research into behavioural health-care practice in a telephonic call centre acting as a point of entry into an Employee Assistance Program (EAP). The goal of the study is to examine the feasibility of implementing routine telephonic alcohol SBIRT in an EAP call centre and assess whether routine SBIRT results in increased identification of workers who misuse alcohol. DESIGN AND METHODS: The design was pretest-posttest, one-group, pre-experimental. An alcohol SBIRT program developed based on World Health Organization recommendations was implemented in one EAP call centre serving one large employer. Workers were offered screening using the Alcohol Use Disorder Identification Test (AUDIT) during intake, brief counselling using motivational interviewing, referral to counselling, and follow-up. RESULTS: At 5 months, 93% of workers contacting the EAP completed the AUDIT-C: 40% prescreened positive and 52% went on to screen at moderate or high risk for an alcohol problem. Overall identification rate (18%) approached general US population estimates. Most agreed to follow-up and three-quarters set an appointment for face-to-face counselling. DISCUSSION AND CONCLUSIONS: Integration of routine alcohol SBIRT into EAP practice is feasible in telephonic delivery systems and increases identification and opportunity for brief motivational counselling. When SBIRT is seamlessly integrated workers are willing to answer questions about alcohol and participate in follow-up.[McPherson TL, Goplerud E, Derr D, Mickenberg J, Courtemanche S. Telephonic screening and brief intervention for alcohol misuse among workers contacting the employee assistance program: A feasibility study.

A field test of a Web-based substance abuse prevention training program for health promotion professionals.

PURPOSE: To evaluate a multimedia substance abuse prevention (SAP) training program for health promotion (HP) practitioners designed to provide opportunities for behavioral modeling and skills building and to motivate and build confidence in ability to integrate SAP into HP offerings. METHODS: Using a posttest only design, 192 practitioners were randomly assigned to receive web-based (experimental group) or print-based (control group) training. Feelings about ability to conduct effective SAP programming, reactions to training materials, and knowledge about substance abuse and how to implement SAP were assessed. The experimental group also rated specific aspects of the web training. RESULTS: The experimental group gave high evaluation ratings, scored significantly higher on self-efficacy items, and gave significantly higher ratings on 12 of 15 reaction items. CONCLUSION: Web-based training was more engaging, understandable, user-friendly, useful, comprehensive, and motivating than print-based training; it is believed to be more effective in helping to integrate substance abuse prevention; and it will serve as a continuous resource.

Substance use in the construction industry: a comparison of assessment methods.

Most users of illicit drugs are employed adults, with substance use rates especially high in the construction industry. In an effort to shed light on the nature and extent of drug use among construction industry workers, and to compare drug use assessment methods, substance use among construction workers, 60% of whom were apprentices, across six sites was assessed by questionnaire, urinalysis, and hair analysis. Nearly 17% of the participants reported current drug use, although drug use differed dramatically by site. Drug use rates also differed by respondent characteristics, participation rates, and assessment method. The strengths and weaknesses of each assessment method are discussed, along with the rationale for combining methods.