Emergency Medicine Peer Outreach Worker Engagement for Recovery
Trial statusRecruiting
Trial phaseNot listed
Trial typeObservational
Biological sexAll
Age18+
SponsorUniversity of California, Los Angeles
About this trial
This is an observational, prospective case-control study evaluating the effects of an emergency department community health worker-peer recovery specialist program (PCHW), the Substance Misuse Assistance Response Team (SMART). Aims of this study are to 1) understand participant experiences working with a SMART PCHW and identify possible mechanisms for successful recovery linkage; 2) Evaluate SMART effectiveness on patient-centered outcomes, building recovery capital, and recovery linkage; 3) Evaluate SMART implementation and effectiveness on patient outcomes over time.
Using a combination of surveys and data linkages to state administrative databases, study investigators will prospectively compare changes in addiction treatment engagement, recovery capital, health related social needs, acute care utilization, and death between people receiving a ED PCHW and those who do not. After consenting to study participation, participants will complete surveys at time of study enrollment and 3 and 6 months after their initial ED visit. Primary outcomes include engagement in addiction treatment, social services engagement, acute care utilization, and mortality will be assessed through linkages to state administrative databases.
Eligibility criteria
This trial accepts healthy volunteersQualifiers
Adults 18 years old or older
Seen and treated at Rhode Island or The Miriam Hospital ED for a substance use-related concern including intoxication, withdrawal, opioid overdose, opioid withdrawal, or substance use-related infection
Able to provide informed consent
Able to provide at least two forms of contact (personal phone, social media, email, or contact information for family or friends)
Disqualifiers
Unable to provide informed consent
In police custody, incarcerated, or have a court ordered treatment enrollment
Trial population
The study will enroll 400 people with a substance-used related visit. Individuals will be approached after receipt of ED services. 1. 200 people who have received SMART services. \- Participants will be approached for study participation after they have already received SMART services. 2. 200 people who did NOT receive SMART services. * Participants will be approached for study enrollment in this study arm when they are seen and treated on a day and time or ED site where SMART is not available.
Trial design
Design model
Case-control
Time perspective
Prospective
Treatments tested in this trial
Substance Misuse Assistance Response Team (SMART)
BehavioralThe study intervention is engagement with a Substance Misuse Assistance Response Team (SMART) community health worker-peer recovery specialist (PCHW). SMART PCHWs engage ED patients with substance use disorders and facilitates ED services provision and linkages to outpatient care. Services provided include supporting ED initiation of buprenorphine, harm reduction services, social services (transportation, housing assistance, etc.), and engagement in peer recovery, behavioral health services, and addiction treatment services. Services are provided at the time of the ED visit. A subgroup of patients is provided short term case management and outpatient services navigation depending on PCHW caseload availability and individual needs.
Usual Care Group
Other interventionPatient not seen by a SMART community health worker in the emergency department. Care and treatment referral at discretion of emergency department treating team.
Treatment groups
400 Participants
are divided into 2 treatment groupsGroup A: SMART Participant1 intervention
Group B: Usual Care1 intervention
Trial outcomes
Primary outcomes
1
Treatment engagement
Investigators will measure engagement in formal addiction treatment at a state licensed addiction treatment facility and/or receipt of office-based buprenorphine through data linkages to the Rhode Island Prescription Drug Monitoring Program database and the Rhode Island Behavioral Health Online Database.
Time frame
Will compare differences in treatment engagement between study arms 3 and 6 months after study enrollment.2
Recovery Capital
Investigators will conduct surveys with study participants at time of enrollment, three months after enrollment, and six months after enrollment. Survey Changes in individual recovery capital as measured by reported self-efficacy, social networks, and quality of life
Time frame
Will compare differences in treatment engagement between study arms 3 and 6 months after study enrollment.Secondary outcomes
1
Emergency Department Utilization
Investigators will measure emergency department utilization through review of health system electronic health records and data linkages to the Rhode Island Emergency Medical Services and Medicaid claims databases.
Time frame
Will compare differences in acute care utilization between study arms 3 and 6 months after study enrollment.2
Repeat Hospitalization
Investigators will measure hospitalizations review of health system electronic health records and data linkages to the Rhode Island Emergency Medical Services and Medicaid claims databases.
Time frame
Will compare differences in acute care utilization between study arms 3 and 6 months after study enrollment.3
Repeat Overdose
Investigators will measure overdose incidence review of health system electronic health records and data linkages to the Rhode Island Emergency Medical Services and Medicaid claims databases.
Time frame
Will compare differences in acute care utilization between study arms 3 and 6 months after study enrollment.4
Mortality
Through linkage to the state vital records database, investigators will compare differences in mortality between study arms.
Time frame
Will compare differences in mortality between study arms 3 and 6 months after study enrollment.Sponsors and contacts
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University of California, Los Angeles
Lead sponsor
Rhode Island Hospital
Collaborator
The Miriam Hospital
Collaborator
Brown University
Collaborator
Source ClinicalTrials.gov