Motivational Interviewing to Reduce Substance Use Among Depression Patients

通过动机访谈减少抑郁症患者的药物使用

• 批准号: 8320386
• 负责人: Derek D Satre
• 金额: $ 21.78万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-25 至 2014-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8320386
• 关键词: Address; Affect; Alcohol abuse; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Antidepressive Agents; Behavioral; Cannabis; Chemical Depression; Chemicals; Clinic; Clinical; Comorbidity; Computerized Medical Record; Control Groups; Data; Dependence; Dependency; Depressed mood; Diagnosis; Diagnostic; Drug Prescriptions; Drug abuse; Drug usage; Drug user; Economics; Effectiveness; Frequencies; Health; Health Maintenance Organizations; Health Services Research; Healthcare; Illicit Drugs; Individual; Intake; Intervention; Intervention Studies; Interview; Managed Care; Mental Depression; Mental Health; Mental disorders; Modeling; Moods; Motivation; National Institute of Drug Abuse; Outcome; Outpatients; Pamphlets; Participant; Patient Care; Patients; Persons; Pharmaceutical Preparations; Population; Prevention; Process; Psychiatry; Public Health; Randomized; Readiness; Relative (related person); Reporting; Research; Research Personnel; Risk; SF-36; Sampling; Screening procedure; Services; Substance Addiction; Substance abuse problem; Telephone; Testing; Time; Visit; Vulnerable Populations; Woman; base; brief motivational intervention; control trial; depressive symptoms; drinking; effective intervention; effectiveness trial; follow-up; functional outcomes; hazardous drinking; high risk; improved; inclusion criteria; innovation; men; misuse of prescription only drugs; motivational enhancement therapy; physical conditioning; prevent; programs; public health relevance; screening, brief intervention, referral, and treatment; service utilization; therapy development; treatment program

DESCRIPTION (provided by applicant): This application by a new investigator responds to PA-08-263, Health Services Research on the Prevention and Treatment of Drug and Alcohol Abuse (R01). We propose a 3-year randomized study of Brief Motivational Intervention (BMI) delivered in the context of the Screening, Brief Intervention and Referral to Treatment (SBIRT) model to reduce drug use and hazardous drinking among outpatients in treatment for depression in a health maintenance organization's large outpatient psychiatry clinic. Patients with depression who use drugs or alcohol even at sub-diagnostic levels can compromise depression treatment and are at high risk for escalation of substance problems. But interventions have not been tested in this large and vulnerable population. BMI is an innovative approach that could decrease drug and alcohol use and improve outcomes for these patients with hazardous drinking and drug use. BMI can facilitate initiation of chemical dependency care for patients with significant substance problems including dependence, as needed, consistent with the SBIRT model. This promising intervention has never been tested among patients with depression. Study inclusion criteria are based on drug use (including any illicit drug use and non-prescribed use of prescription drugs) and hazardous drinking (i.e., e 3 drinks in a day for women and e 4 drinks in a day for men), and moderate to severe depression symptoms at the time of intake. In this controlled trial, 350 patients will be randomized to receive one in-person BMI session and two telephone BMI booster sessions within 8 weeks of intake (intervention) or a brochure on risks of drug and alcohol use (control). We anticipate that the intervention will be effective in reducing frequency of drug use and hazardous drinking at 3-, 6- and 12-month follow-up interviews, relative to patients in the control group; improving mood and functional outcomes; increasing depression treatment retention (number of psychiatry visits recorded in the electronic medical record, based on Healthcare Effectiveness Data and Information Set (HEDIS) standards); and facilitating patient initiation of chemical dependency program treatment. If effectiveness is demonstrated, BMI could have a major impact on services for patients with depression. PUBLIC HEALTH RELEVANCE: Drug and alcohol use among depression patients is very prevalent and puts patients at risk for worsening substance problems and poor mental health outcomes. The study intervention (BMI) is an innovative treatment with significant potential to reduce drug and alcohol use in this population. If effectiveness is demonstrated, the intervention could improve services for patients with depression, prevent escalation of drug and alcohol problems and improve health outcomes.

描述（由申请人提供）：新研究者的此申请响应 PA-08-263，《预防和治疗药物和酒精滥用的卫生服务研究》(R01)。我们提出了一项为期 3 年的随机研究，在筛查、简短干预和转介治疗 (SBIRT) 模式的背景下进行简短动机干预 (BMI)，以减少门诊抑郁症治疗患者的药物使用和危险饮酒，以维持健康组织的大型精神病诊所。抑郁症患者即使在亚诊断水平下使用药物或酒精也会影响抑郁症的治疗，并且物质问题升级的风险很高。但干预措施尚未在这一庞大且脆弱的人群中进行过测试。 BMI 是一种创新方法，可以减少药物和酒精的使用，并改善这些危险饮酒和药物滥用患者的治疗结果。 BMI 可以根据需要促进对有严重物质问题（包括依赖）的患者开始化学依赖护理，这与 SBIRT 模型一致。这种有希望的干预措施从未在抑郁症患者中进行过测试。研究纳入标准基于药物使用（包括任何非法药物使用和处方药的非处方使用）和危险饮酒（即女性每天饮酒 3 杯，男性每天饮酒 4 杯），以及中等程度摄入时出现严重的抑郁症状。在这项对照试验中，350 名患者将被随机分配，接受 1 次现场 BMI 治疗和 2 次电话 BMI 强化治疗（干预），并在服用后 8 周内接受药物和酒精使用风险手册（对照）。我们预计，相对于对照组患者，在 3、6 和 12 个月的随访访谈中，该干预措施将有效减少吸毒和危险饮酒的频率；改善情绪和功能结果；增加抑郁症治疗保留率（根据医疗保健有效性数据和信息集（HEDIS）标准，记录在电子病历中的精神病科就诊次数）；并促进患者开始化学依赖计划治疗。如果有效性得到证实，BMI 可能会对抑郁症患者的服务产生重大影响。 公共卫生相关性：抑郁症患者吸毒和酗酒的情况非常普遍，使患者面临物质问题恶化和心理健康结果不佳的风险。该研究干预（BMI）是一种创新疗法，具有减少该人群吸毒和酗酒的巨大潜力。如果证明有效，该干预措施可以改善抑郁症患者的服务，防止毒品和酒精问题升级，并改善健康结果。

项目成果

Cost-Effectiveness of Motivational Interviewing to Reduce Alcohol and Cannabis Use Among Patients With Depression.

动机访谈减少抑郁症患者饮酒和大麻使用的成本效益。

• 发表时间: 2022-09
• 作者: Satre, Derek D;Parthasarathy, Sujaya;Young;Meacham, Meredith C;Borsari, Brian;Hirschtritt, Matthew E;Van Dyke, Lucas;Sterling, Stacy A
• 通讯作者: Sterling, Stacy A