The purpose of this study is to evaluate the feasibility and preliminary effectiveness of a primary care-based Interdisciplinary Addiction Care Transition (IntACT) team that will meet patients with substance use disorders (SUD) during a medical hospitalization and provide intensive care management, peer support, and interim SUD and medical care after discharge while facilitating a transition to long term community-based treatment.
Aged 18 years and older
Hospitalized at University of Utah Medical Center (UUMC) for any medical reason, and
Electronic Health Record (EHR) documented diagnosis of any SUD.
Currently incarcerated
Tobacco use as only documented substance use disorder
Parallel
IntACT
BehavioralParticipants randomized to IntACT will receive usual inpatient and outpatient services plus an interdisciplinary addiction care transition team providing: (1) in-hospital discharge planning support, (2) proactive post-discharge outreach and care coordination, (3) intensive care management and peer support, and (4) interim SUD and medical care coordination for up to 4 months post-randomization, with the goal of facilitating transition to longitudinal community-based care.
Usual Care
BehavioralParticipants randomized to Usual Care will receive standard of care services routinely available at University of Utah Health, including inpatient addiction consult services when ordered, discharge planning by hospital medical and social work teams, and referrals/follow-up options based on insurance and patient preference. Usual Care participants will not receive the structured IntACT intervention components provided in the intervention arm, including proactive post-discharge outreach by the IntACT care manager/peer support specialist, intensive care management, dedicated peer navigation, scheduled interdisciplinary team review, or interim addiction/primary care transition services delivered by the IntACT team as part of the study. If a Usual Care participant independently establishes care with SPARC clinic or other services through standard referral pathways, this will be permitted and will be captured as part of outcome assessment.
Care Linkage
percentage of patients who attend any follow up visit within 14 days of hospital discharge. Assessed using administrative records and patient self-report.
Retention in Treatment
Percentage of patients who have attended a medical or substance use treatment appointment within the past 30 days. Assessed at 2 months, 4 months, and 6 months after randomization. Assessed using clinic/administrative records and patient-self-report.
Intervention Feasibility
Implementation-related outcomes will be collected from N=20 clinicians who are exposed to the IntACT intervention and IntACT team members, respectively. Implementation outcomes include Feasibility, assessed via the 4-item Feasibility of Intervention measure (range 0-12, higher is more feasible)
Intervention Acceptability
Implementation-related outcomes will be collected from N=20 clinicians who are exposed to the IntACT intervention and IntACT team members, respectively. Implementation outcomes include Acceptability, assessed via the 4-item Acceptability of Intervention measure (range 0-12, higher is more acceptible)
Time to first follow-up visit, assessed using clinic/administrative records and participant self-report.
Time until participant presents for first follow up visit.
Emergency Department visits and hospitalizations
Number of self-reported ED visits and re-hospitalizations
Substance use
Number of self-reported substance uses using Timeline Follow Back
Participant quality of life
Quality of life outcomes measured by the 12-Item Short Form Health Survey (range 0-100, hgiher score means greater quality of life), a self-reported questionnaire assessing functional health and well-being,
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Michael Incze
Lead sponsor
University of Utah
Sponsor institution
National Institute on Drug Abuse (NIDA)
Collaborator
