Buprenorphine and Integrated HIV Care Evaluation

NCT ID: NCT00124358

Last Updated: 2007-03-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

1350 participants

Study Classification

INTERVENTIONAL

Study Start Date

2005-08-31

Study Completion Date

2008-12-31

Brief Summary

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The purpose of this study is to assess the feasibility, cost and effectiveness of interventions designed to integrate buprenorphine treatment for opioid dependence into HIV primary care in ten HIV care centers in the U.S.

Detailed Description

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Programs that integrate medical care and drug treatment have shown great promise in improving health and substance use related outcomes. The overlap in the epidemics of HIV (with its complex medical needs) and drug abuse makes HIV-infected drug users a population likely to benefit from the integration of primary care and drug treatment. The Drug Addiction Treatment Act of 2000 and the approval of buprenorphine for the office-based treatment of opioid addiction provide a new opportunity to integrate addiction treatment and medical care for people with HIV. Research has demonstrated the effectiveness of buprenorphine in reducing illicit drug use among opioid dependent people. However, little is known about implementing such programs in HIV care settings, their cost, what effect they have on the health outcomes and substance use behavior of PLWH/A, or their broader impact on providers, institutions, and local systems.

Through this study, approximately 1,350 HIV-infected individuals who meet criteria for opioid dependence will be selected by eleven model demonstration projects located in ten HIV care centers across the U.S. Information on patients' drug use, HIV health status, service utilization, quality of life, and satisfaction with services as well as information about providers' practices and attitudes towards treating drug dependent patients will be collected through face-to-face interviews, audio computer-assisted self-interviewing, written surveys, and chart abstractions. These data will be used to help replicate effective programs that integrated HIV care and drug treatment and to improve the care of HIV-infected opioid dependent individuals.

Comparisons: All eleven programs will compare a group of patients who receive integrated buprenorphine treatment and HIV care to a group of patients who receive an alternate intervention. However, the program designs and comparison group interventions vary across the sites and are locally determined. Some sites will implement randomized control designs, while others will use observational methods.

Conditions

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Opioid-Related Disorders HIV Infections AIDS

Keywords

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Drug Abuse Drug Addiction Drug Dependence Drug Use Disorders Drug Use Disorder Substance Abuse Substance Use Disorder Buprenorphine Opiate Addiction Substance-related disorders HIV

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Interventions

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Buprenorphine

Intervention Type DRUG

Integrated HIV care and office-based opioid dependence treatment

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* HIV-infected
* Clinical diagnosis of opioid dependence
* Fluent in English or Spanish
* 18 years or older

Exclusion Criteria

* Liver function tests (transaminase only) at five times or higher than normal level;
* Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) criteria for benzodiazepine abuse or dependence within the past 6 months;
* DSM-IV criteria for alcohol dependence within the past 6 months;
* Actively suicidal;
* Psychiatric impairment that impedes ability to consent (dementia, delusional, actively psychotic);
* Methadone dose exceeding levels allowing for safe transition to buprenorphine;
* Pregnant women and women actively trying to become pregnant;
* Clinical judgment of local site principal investigator that patient is inappropriate
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Health Resources and Services Administration (HRSA)

FED

Sponsor Role collaborator

El Rio Santa Cruz Neighborhood Health Center

UNKNOWN

Sponsor Role collaborator

Organization to Achieve Solutions in Substance Abuse (OASIS)

OTHER

Sponsor Role collaborator

Oregon Health and Science University

OTHER

Sponsor Role collaborator

Montefiore Medical Center

OTHER

Sponsor Role collaborator

University of Miami

OTHER

Sponsor Role collaborator

Brown University

OTHER

Sponsor Role collaborator

University of California, San Francisco

OTHER

Sponsor Role collaborator

Johns Hopkins University

OTHER

Sponsor Role collaborator

CORE Center, Cook County Bureau of Health Services

UNKNOWN

Sponsor Role collaborator

Yale University

OTHER

Sponsor Role collaborator

The New York Academy of Medicine

OTHER

Sponsor Role lead

Principal Investigators

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Ruth Finkelstein, ScD

Role: PRINCIPAL_INVESTIGATOR

New York Academy of Medicine

David Fiellin, MD

Role: PRINCIPAL_INVESTIGATOR

Yale University

Locations

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El Rio Santa Cruz Neighborhood Health Center

Tucson, Arizona, United States

Site Status RECRUITING

Organization to Achieve Solutions in Substance Abuse

Oakland, California, United States

Site Status RECRUITING

University of California San Francisco

San Francisco, California, United States

Site Status RECRUITING

Yale University School of Medicine AIDS Program

New Haven, Connecticut, United States

Site Status RECRUITING

University of Miami School of Medicine

Miami, Florida, United States

Site Status RECRUITING

The CORE Center

Chicago, Illinois, United States

Site Status RECRUITING

Johns Hopkins University

Baltimore, Maryland, United States

Site Status RECRUITING

Montefiore Medical Center

New York, New York, United States

Site Status RECRUITING

Oregon Health & Science University

Portland, Oregon, United States

Site Status RECRUITING

The Miriam Hospital

Providence, Rhode Island, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Ruth Finkelstein, ScD

Role: CONTACT

Phone: 212.822.7266

Email: [email protected]

James E Egan, MPH

Role: CONTACT

Phone: 212.822.7347

Email: [email protected]

Facility Contacts

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Jeff Thomas, ACSW

Role: primary

Laphyne Barrett, MA

Role: primary

Bob Thawley

Role: primary

Declan Barry, PhD

Role: primary

Leslie Thompson, RN, BSN

Role: primary

Mary Jo Tozzi

Role: primary

Greg Lucas, MD, PhD

Role: primary

Galit Sacajiu, MD

Role: primary

Catherine Pedersen, MPA

Role: primary

Helen Loewenthal, MSW

Role: primary

Other Identifiers

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H97HA03795

Identifier Type: -

Identifier Source: secondary_id

063005

Identifier Type: -

Identifier Source: org_study_id