Improving Retention across the OUD Service Cascade upon Re-entry from Jail using Recovery Management Checkups

使用恢复管理检查提高从监狱重新进入时整个 OUD 服务级联的保留

• 批准号: 9978008
• 负责人: Christy K Scott
• 金额: $ 189.9万
• 依托单位: CHESTNUT HEALTH SYSTEMS, INC.
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-15 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9978008
• 关键词: Address; Alcohol or Other Drugs use; Caring; Chronic; Collaborations; Communities; Complement; County; Crime; Effectiveness; Eligibility Determination; Enrollment; Evidence based intervention; Female; Frequencies; Future; Goals; Health; Health Care Costs; Health Personnel; Household; Illinois; Imprisonment; Individual; Intercept; Intervention; Interview; Jail; Justice; Link; Modeling; Monitor; Nature; Opioid; Outcome; Overdose; Participant; Pattern; Persons; Population; Public Health; Quality of life; Quality-Adjusted Life Years; Randomized; Randomized Controlled Trials; Recording of previous events; Records; Recovery; Relapse; Reporting; Research; Resources; Safety; Schedule; Services; Symptoms; System; Testing; Time; Treatment outcome; Urine; Variant; addiction; base; checkup examination; community based treatment; cost; cost effective; cost effectiveness; experimental study; follow-up; health care service utilization; high risk; improved; incremental cost-effectiveness; innovation; male; medication-assisted treatment; mortality; offender; opioid epidemic; opioid use; opioid use disorder; recidivism; relapse risk; retention rate; safety outcomes; scale up; treatment comparison; treatment duration; trial comparing; Address; Alcohol or Other Drugs use; Caring; Chronic; Collaborations; Communities; Complement; County; Crime; Effectiveness; Eligibility Determination; Enrollment; Evidence based intervention; Female; Frequencies; Future; Goals; Health; Health Care Costs; Health Personnel; Household; Illinois; Imprisonment; Individual; Intercept; Intervention; Interview; Jail; Justice; Link; Modeling; Monitor; Nature; Opioid; Outcome; Overdose; Participant; Pattern; Persons; Population; Public Health; Quality of life; Quality-Adjusted Life Years; Randomized; Randomized Controlled Trials; Recording of previous events; Records; Recovery; Relapse; Reporting; Research; Resources; Safety; Schedule; Services; Symptoms; System; Testing; Time; Treatment outcome; Urine; Variant; addiction; base; checkup examination; community based treatment; cost; cost effective; cost effectiveness; experimental study; follow-up; health care service utilization; high risk; improved; incremental cost-effectiveness; innovation; male; medication-assisted treatment; mortality; offender; opioid epidemic; opioid use; opioid use disorder; recidivism; relapse risk; retention rate; safety outcomes; scale up; treatment comparison; treatment duration; trial comparing

7. Abstract Jails provide an optimal setting for intervening with individuals with opioid use disorders (OUD), given the high volume of offenders with OUD, and their high risk of relapse to opioids following their release to the community. It is imperative that individuals with OUD are linked to community-based medication assisted treatment (MAT) upon their re-entry, as well as receive support for their ongoing treatment retention and recovery. The proposed experiment will test an adapted version of an evidence-based intervention, the Recovery Management Checkups (RMC) model, which provides quarterly check-ups and assistance with treatment retention and re-linkage as indicated at the quarterly check-ups. The RMC-Adapted will adjust the frequency and intensity of check-ups based on the individual’s assessed need for treatment, thereby reducing (or lengthening) the time between check-ups for those with (or without) indicators of treatment need. The proposed experiment will compare treatment linkage and retention rates as well as public health and public safety outcomes of 750 male and female offenders randomly assigned to 1 of 3 groups upon release from jail: a) a re-entry as usual (control), b) the original RMC, and c) a RMC-Adaptive version tailored to the participant’s need for treatment. The study will be conducted in collaboration with 6 county jails in Illinois and the MAT providers that currently provide pre- and post-release MAT to offenders with OUD. Pre-release, participants will be screened for history of OUD and eligibility for MAT. All participants will receive research follow-up interviews quarterly for 2 years, which will also include urine testing and records checks (treatment, mortality, recidivism). The study aims are to evaluate: (1) the direct effects of RMC and/or RMC-Adaptive on the OUD service cascade of care (initiation, engagement, retention, re-linkage, and months of MAT participation); (2) the indirect effects of RMC and/or RMC-Adaptive (via months of MAT participation) on public health outcomes (days of opioid use, OUD symptoms, quality of life and the cost of health-care utilization); (3) the indirect effects of RMC and/or RMC-Adaptive (via months of MAT and public health outcomes) on public safety outcomes (illegal activity, re-arrest, re-incarceration, and cost of crime); and (4) the incremental costs and cost-effectiveness of the control vs. RMC vs. RMC-Adaptive in terms of both public health outcomes (days of opioid use, quality adjusted life years [QALYs], cost-of-health-care utilization) and public safety outcomes (re-incarceration and cost of crime). The study will determine if tailoring the checkups to individual’s need for treatment leads to more efficient targeting of resources to those in need, reduces the intervention burden on those with lower need, and results in an improved overall effectiveness and cost-effectiveness of RMC checkups.

7。摘要 监狱为与患有绿气剂使用障碍的人（OUD）提供了最佳的环境，鉴于高 释放到阿片类药物的罪犯的数量以及他们释放到阿片类药物的高风险 社区。必须将OUD的个人与社区药物协助链接 对其重新进入（MAT）的治疗（MAT），并为他们的持续治疗保留和 恢复。拟议的实验将测试基于证据的干预措施的改编版本 恢复管理检查（RMC）模型，该模型提供季度检查和协助 如季度检查所示，治疗保留和重新连接。 RMC适应的将调整 根据个人评估的治疗需求，检查的频率和强度，从而减少 （或延长）检查需要（或没有）需要指标的人的检查时间。这 拟议的实验将比较治疗联系和保留率以及公共卫生和公众 从监狱释放时，有750名男性和女性罪犯的安全成果随机分配给了3组中的1个： a）像往常 需要治疗。该研究将与伊利诺伊州的6个县监狱和垫子合作进行 目前，使用OUD向罪犯提供释放前和后发行后垫的提供者。预发行，参与者会 要筛选OUD的历史和MAT的资格。所有参与者将接受研究后续采访 季度持续2年，还将包括尿液测试和记录检查（治疗，死亡率，累犯）。 该研究的目的是评估：（1）RMC和/或RMC自适应对OUD服务的直接影响 级联护理（启动，参与，保留，重新连接和垫子参与的月）； （2）间接 RMC和/或RMC自适应（通过MAT参与的几个月）对公共卫生结果的影响（几天 OPIOED使用，OUD症状，生活质量和医疗保健利用的成本）； （3）RMC的间接影响 和/或RMC自适应（通过MAT和公共卫生成果数月）公共安全成果（非法 活动，重新逮捕，重新监禁和犯罪成本）； （4）增量成本和成本效益 根据公共卫生结果（阿片类药物的日子，质量 调整后的终身年份[QALYS]，卫生费用利用率）和公共安全成果（重新监禁和 犯罪费用）。该研究将确定是否针对个人对治疗需求进行裁缝是否导致 将资源更有效地针对有需要的人，减少伯恩的干预措施 需求，并提高了RMC检查的总体效率和成本效益。