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The Effectiveness of Telephone-Based Continuing Care for Alcohol and Cocaine Dependence. 24-Month Outcomes
(Efficacité du suivi du traitement via le téléphone pour la dépendance à l'alcool et à la cocaïne. Résultats sur 24 mois)
Auteur(s) :
J. R. McKAY ;
K. G. LYNCH ;
D. S. SHEPARD ;
H. M. PETTINATI
Article en page(s) :
199-207
Refs biblio. :
57
Domaine :
Plusieurs produits / Several products
Langue(s) :
Anglais
Thésaurus mots-clés
TELEPHONE
;
EFFICACITE
;
TRAITEMENT
;
ALCOOL
;
COCAINE
;
DEPENDANCE
;
SUIVI DU PATIENT
Thésaurus géographique
ETATS-UNIS
Note générale :
Archives of General Psychiatry, 2005, 62, (2), 199-207
Note de contenu :
graph. ; tabl.
Résumé :
ENGLISH :
CONTEXT: Telephone-based disease management protocols have shown promise in improving outcomes in a number of medical and psychiatric disorders, but this approach to continuing care has received little study in alcohol- and drug-dependent individuals. OBJECTIVE: To compare telephone-based continuing care with 2 more intensive face-to-face continuing care interventions. DESIGN: A randomized 3-group clinical trial with a 2-year follow-up. SETTING: Two outpatient substance abuse treatment programs, one community-based and the other at a Veterans Affairs medical center facility. PATIENTS: Alcohol- and/or cocaine-dependent patients (N = 359) who had completed 4-week intensive outpatient programs. INTERVENTIONS: Three 12-week continuing care treatments: weekly telephone-based monitoring and brief counseling contacts combined with weekly supportive group sessions in the first 4 weeks (TEL), twice-weekly cognitive-behavioral relapse prevention (RP), and twice-weekly standard group counseling (STND). MAIN OUTCOME MEASURES: Percentage of days abstinent from alcohol and cocaine, total abstinence from alcohol and cocaine, negative consequences of substance use, cocaine urine toxicological results, and gamma-glutamyltransferase. RESULTS: Participants in TEL had higher rates of total abstinence over the follow-up than those in STND (P<.05 in alcohol-dependent participants gamma-glutamyltransferase levels were lower tel than rp .005 cocaine-dependent there was a significant group x time interaction .03 which the rate of cocaine-positive urine samples increased more rapidly as compared with tel. on percentage days abstinent or negative consequences substance use did not differ from stnd. high scores composite risk indicator based co-occurring alcohol and cocaine dependence poor progress toward achieving intensive outpatient program goals had better total abstinence outcomes up to months if they received stnd rather whereas those higher rates .04 conclusions: telephone-based continuing care appears be an effective form step-down treatment for most patients who complete initial stabilization face-to-face interventions. however high-risk may have first receive counseling after completing programs. s abstract>
ENGLISH :
CONTEXT: Telephone-based disease management protocols have shown promise in improving outcomes in a number of medical and psychiatric disorders, but this approach to continuing care has received little study in alcohol- and drug-dependent individuals. OBJECTIVE: To compare telephone-based continuing care with 2 more intensive face-to-face continuing care interventions. DESIGN: A randomized 3-group clinical trial with a 2-year follow-up. SETTING: Two outpatient substance abuse treatment programs, one community-based and the other at a Veterans Affairs medical center facility. PATIENTS: Alcohol- and/or cocaine-dependent patients (N = 359) who had completed 4-week intensive outpatient programs. INTERVENTIONS: Three 12-week continuing care treatments: weekly telephone-based monitoring and brief counseling contacts combined with weekly supportive group sessions in the first 4 weeks (TEL), twice-weekly cognitive-behavioral relapse prevention (RP), and twice-weekly standard group counseling (STND). MAIN OUTCOME MEASURES: Percentage of days abstinent from alcohol and cocaine, total abstinence from alcohol and cocaine, negative consequences of substance use, cocaine urine toxicological results, and gamma-glutamyltransferase. RESULTS: Participants in TEL had higher rates of total abstinence over the follow-up than those in STND (P<.05 in alcohol-dependent participants gamma-glutamyltransferase levels were lower tel than rp .005 cocaine-dependent there was a significant group x time interaction .03 which the rate of cocaine-positive urine samples increased more rapidly as compared with tel. on percentage days abstinent or negative consequences substance use did not differ from stnd. high scores composite risk indicator based co-occurring alcohol and cocaine dependence poor progress toward achieving intensive outpatient program goals had better total abstinence outcomes up to months if they received stnd rather whereas those higher rates .04 conclusions: telephone-based continuing care appears be an effective form step-down treatment for most patients who complete initial stabilization face-to-face interventions. however high-risk may have first receive counseling after completing programs. s abstract>
Affiliation :
Department of Psychiatry, University of Pennsylvania, Philadelphia, PA. Email : mckay_j@mail.trc.upenn.edu
Etats-Unis. United States.
Etats-Unis. United States.
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