Increasing Treatment Adherence in Co-Occurring Psychiatric and Drug Use Disorders

NCT ID: NCT00237822

Last Updated: 2017-10-17

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

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

75 participants

Study Classification

INTERVENTIONAL

Study Start Date

2003-09-30

Study Completion Date

2007-12-31

Brief Summary

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The investigators are proposing a study of treatment adherence in co-occurring psychiatric and drug use disorders (COD). The proposed study uses a 3-cell/condition design, within which 75 adult outpatients with co-occurring psychiatric disorders and drug abuse/dependence (CODDA) will be randomly assigned to one of the following brief, 8-week, manual-guided interventions following a 2-week "Assessment Only" baseline period:

1. Adherence Feedback (AF); this condition will entail weekly, 20-25 minute sessions of AF, which is a procedure that represents a technological advancement developed by Cramer et al. (1989, 1995, and 1999) and is based on the use of adherence data from the microelectronic monitor in Medication Event Monitoring System (MEMS) caps,
2. AF + Contingency Management (AF + CM); in this condition, participants will receive AF, as described above, PLUS contingency management. CM is based on the behavioral learning theory, which suggests that the occurrence of a behavior is increased as a function of the rate at which it is positively reinforced or rewarded, or
3. AF + Motivational Enhancement Therapy (AF + MET); in this condition, patients will receive AF, as described above, PLUS motivational enhancement therapy. MET is based on the idea that an effective way to motivate behavior change is to assist patients in clarifying their ambivalence (i.e., reasons for and against changing/adhering), utilizing a series of strategies based on client-centered psychotherapy, self-efficacy theory, and social psychology.

The study will allow the evaluation of three hypotheses:

1. AF + MET is superior to AF + CM,
2. AF + MET is superior to AF alone, and
3. AF + CM is superior to AF alone.

Primary outcome measures are:

1. rates of adherence to medication (i.e., selective serotonin reuptake inhibitors or SSRIs), as measured by MEMS caps and self-report,
2. rates of counseling attendance, and
3. reductions in illicit drug use, including achievement of abstinence, as assessed by twice-weekly urine toxicology tests and self-report.

Secondary outcomes include reductions in psychiatric symptomatology and rates of re-hospitalization. The investigators will also evaluate the relationship between adherence and primary and secondary outcomes.

Detailed Description

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Conditions

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Diagnosis, Dual (Psychiatry) Psychiatric Diagnosis Drug Use Disorders

Keywords

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Treatment Adherence Co-Occurring Disorders Motivational Enhancement Therapy Contingency Management MEMS Caps

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

SINGLE

Interventions

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Adherence Feedback (AF)

Intervention Type BEHAVIORAL

AF + Contingency Management (AF + CM)

Intervention Type BEHAVIORAL

AF + Motivational Enhancement Therapy (AF + MET)

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Currently being treated with any class of psychotropic medication
* Have used illicit drugs or abused prescription drugs within the past year
* Are not adhering completely to their medication

Exclusion Criteria

* Current major depressive episode
* Active suicidal/homicidal ideation/intent
* Current manic episode
* Visiting nurse or living in a facility that distributed medications
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute on Drug Abuse (NIDA)

NIH

Sponsor Role collaborator

Yale University

OTHER

Sponsor Role lead

Principal Investigators

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Michael V. Pantalon, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Yale University

Locations

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Yale University Substance Abuse Center

New Haven, Connecticut, United States

Site Status

Countries

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United States

Other Identifiers

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K23DA015144

Identifier Type: NIH

Identifier Source: secondary_id

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K23DA015144

Identifier Type: NIH

Identifier Source: org_study_id

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