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: 10615752
• 负责人: MICHAEL L DENNIS
• 金额: $ 182.23万
• 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 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10615752
• 关键词: Address; 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; Needs Assessment; Opioid; Outcome; Overdose; Participant; Persons; Policy Maker; Population; Prediction of Response to Therapy; 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; checkup examination; community based treatment; cost; cost effective; cost effectiveness; experimental study; follow-up; health care service utilization; high risk; improved; incremental cost; innovation; male; medication-assisted treatment; mortality; offender; opioid epidemic; opioid use; opioid use disorder; rearrest; recidivism; reincarceration; relapse risk; retention rate; safety outcomes; scale up; substance use; substance use treatment; treatment comparison; treatment duration; treatment pattern; 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 鉴于阿片类药物使用障碍 (OUD) 患者的高发病率，监狱为干预提供了最佳环境。 使用 OUD 的罪犯数量，以及他们被释放到阿片类药物后复发的高风险 OUD 患者必须接受基于社区的药物辅助。 重新入境后接受治疗 (MAT)，并为其持续治疗保留提供支持 拟议的实验将测试基于证据的干预措施的改编版本，即“恢复”。 恢复管理检查 (RMC) 模型，提供季度检查和帮助 季度检查中显示的治疗保留和重新连接 RMC-Adapted 将调整治疗。 根据个人评估的治疗需求确定检查的频率和强度，从而减少 （或延长）对有（或没有）需要治疗迹象的患者进行检查的时间间隔。 拟议的实验将比较治疗联系和保留率以及公共卫生和公共健康 750 名男性和女性罪犯出狱后被随机分配到 3 组中的一组的安全结果： a) 照常重新进入（对照），b) 原始 RMC，以及 c) 根据参与者的情况量身定制的 RMC 自适应版本 该研究将与伊利诺伊州的 6 个县监狱和 MAT 合作进行。 目前向犯罪者提供 OUD 释放前和释放后 MAT 的提供商，参与者将这样做。 接受 OUD 历史和 MAT 资格筛查 所有参与者都将接受研究后续访谈。 两年内每季度进行一次，其中还包括尿液检测和记录检查（治疗、死亡率、累犯）。 该研究的目的是评估：(1) RMC 和/或 RMC-Adaptive 对 OUD 服务的直接影响 护理级联（启动、参与、保留、重新联系和 MAT 参与月数）；(2) 间接护理 RMC 和/或 RMC-Adaptive（通过 MAT 参与数月）对公共卫生结果（参与的天数）的影响 (3)RMC的间接影响 和/或 RMC-Adaptive（通过数月的 MAT 和公共卫生结果）对公共安全结果（非法 活动、再次逮捕、再次监禁和犯罪成本）；以及 (4) 增量成本和成本效益 就公共健康结果（阿片类药物使用天数、质量 调整后的生命年 [QALY]、医疗保健利用成本）和公共安全结果（重新监禁和 犯罪成本）。该研究将确定根据个人的治疗需求定制检查是否会带来好处。 更有效地向有需要的人提供资源，减少对贫困人口的干预负担 需求，从而提高 RMC 检查的整体有效性和成本效益。

项目成果

Access to Services for Pregnant People With Opioid Use Disorder in Jails in the United States.

为美国监狱中患有阿片类药物使用障碍的孕妇提供服务。

• DOI: 10.1089/jchc.22.03.0023
• 发表时间: 2023
• 期刊: Journal of correctional health care : the official journal of the National Commission on Correctional Health Care
• 作者: Grella,ChristineE;Scott,ChristyK;Dennis,MichaelL;LaVallee,RobinA
• 通讯作者: LaVallee,RobinA

Availability of best practices for opioid use disorder in jails and related training and resource needs: findings from a national interview study of jails in heavily impacted counties in the U.S.

• DOI: 10.1186/s40352-022-00197-3
• 发表时间: 2022-12-20
• 期刊: Health & justice
• 影响因子: 3.5

Impact of implementation interventions to improve substance use service delivery on recidivism among justice-involved youth.

• DOI: 10.1186/s40352-023-00210-3
• 发表时间: 2023-02-28
• 期刊: Health & justice
• 影响因子: 3.5

Improving retention across the OUD service cascade upon reentry from jail using Recovery Management Checkups-Adaptive (RMC-A) experiment.

• DOI: 10.1016/j.jsat.2020.108245
• 发表时间: 2021-09
• 期刊: Journal of substance abuse treatment
• 影响因子: 3.9
• 作者: Scott CK;Dennis ML;Grella CE;Watson DP
• 通讯作者: Watson DP

Scoping review of interventions to link individuals to substance use services at discharge from jail.

• DOI: 10.1016/j.jsat.2021.108718
• 发表时间: 2022-07
• 期刊: JOURNAL OF SUBSTANCE ABUSE TREATMENT
• 影响因子: 3.9
• 作者: Grella, Christine E.;Ostlie, Erika;Watson, Dennis P.;Scott, Christy K.;Carnevale, John;Dennis, Michael L.
• 通讯作者: Dennis, Michael L.