Article proves our point.

By October 22, 2015Uncategorized

This is a journal article from JAMA 2013 concerning chronic care management of AOD dependence done by Dr. Richard Saitz out of Boston University.

It is important to ICOTP because of what they DID NOT do in their study.

This study attempted to treat AOD as a chronic disease with a chronic care model, and compare the outcomes to those receiving routine care in a primary care practice.  They did not show any difference in outcomes for those treated routinely compared to those with additional appointments and follow up and referrals.

In my opinion, this article is very much in our favor for promoting the five year plan, because it DOES NOT include any interventions or family involvement,  no real accountability provided to those in the chronic care model, and no random drug screens.  They achieved no benefit to using  their model without these actions.  This shows the importance of these missing components.  I have posted another article from the Federation of Physician Health Programs showing the definite benefit demonstrated in several studies using a chronic care model that does include  leverage and accountability that family interventions, case managers and random drug screens do provide.

R. Reeves, MD

 

OriginalInvestigation | September18,2013

Chronic Care Management for Dependence on

Alcohol and Other Drugs

The AHEAD Randomized Trial

Richard Saitz, MD, MPH1,2,3; Debbie M. Cheng, ScD1,2,4; Michael Winter, MPH5; Theresa W. Kim, MD1,2; Seville M. Meli, MPH1,2; Don Allensworth-Davies, PhD, MSc5,6; Christine A. Lloyd-Travaglini, MPH5; Jeffrey H. Samet, MD, MA, MPH1,2,3

[+] Author Affiliations

JAMA. 2013;310(11):1156-1167. doi:10.1001/jama.2013.277609.

ABSTRACT

ABSTRACT | METHODS | RESULTS | DISCUSSION | CONCLUSION | ARTICLE INFORMATION | REFERENCES

OriginalInvestigation | September18,2013

Chronic Care Management for Dependence on

Alcohol and Other Drugs

The AHEAD Randomized Trial

Richard Saitz, MD, MPH1,2,3; Debbie M. Cheng, ScD1,2,4; Michael Winter, MPH5; Theresa W. Kim, MD1,2; Seville M. Meli, MPH1,2; Don Allensworth-Davies, PhD, MSc5,6; Christine A. Lloyd-Travaglini, MPH5; Jeffrey H. Samet, MD, MA, MPH1,2,3

[+] Author Affiliations

JAMA. 2013;310(11):1156-1167. doi:10.1001/jama.2013.277609.

Importance People with substance dependence have health consequences, high health care utilization, and frequent comorbidity but often receive poor-quality care. Chronic care management (CCM) has been proposed as an approach to improve care and outcomes.

Objective To determine whether CCM for alcohol and other drug dependence improves substance use outcomes compared with usual primary care.

Design, Setting, and Participants The AHEAD study, a randomized trial conducted among 563 people with alcohol and other drug dependence at a Boston, Massachusetts, hospital-based primary care practice. Participants were recruited from September 2006 to September 2008 from a freestanding residential detoxification unit and referrals from an urban teaching hospital and advertisements; 95% completed 12-month follow-up.

Interventions Participants were randomized to receive CCM (n=282) or no CCM (n=281). Chronic care management included longitudinal care coordinated with a primary care clinician; motivational enhancement therapy; relapse prevention counseling; and on-site medical, addiction, and psychiatric treatment, social work assistance, and referrals (including mutual help). The no CCM (control) group received a primary care appointment and a list of treatment resources including a telephone number to arrange counseling.

Main Outcomes and Measures The primary outcome was self-reported abstinence from opioids, stimulants, or heavy drinking. Biomarkers were secondary outcomes.

Results There was no significant difference in abstinence from opioids, stimulants, or heavy drinking

Full article:

http://jama.jamanetwork.com/article.aspx?articleid=1738895

 

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