"Effectiveness of a Brief Intervention for Substances Consumption Linked to the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): A Randomized Control Trial in Chilean Primary Care."
NCT ID: NCT01573416
Last Updated: 2013-10-09
Study Results
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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COMPLETED
PHASE3
400 participants
INTERVENTIONAL
2011-12-31
2013-04-30
Brief Summary
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In Chile, the consumption pattern in 2008 showed that 49.8 % consumed at least once in the last month for alcohol, 3.5 % for marihuana and 1.3 % for cocaine. This prevalence was even greater in young adults and adolescents and is associated with other mental health issues and poorer life quality. Those who have consumed marihuana during the last year, 25% report dependence symptoms. For cocaine derives, dependency rises up to 50% among the consumers. This data reinforce the need to design and implement strategies for reducing alcohol and drugs consumption in our population.
Also, it is well known that a high number of those who suffers from any addiction problem do not get attention in a specialized center. The are many barriers to do so, such as lack of motivation, lack of resources, social problems, access to care problems, and so on.
Chile has a shortage of preventive interventions for those at risk to develop an addiction at an early stage of substance use because front line health services (Primary health care and emergency care) and other social services (police stations, local justice courts) do not have a screening system and a model of brief intervention.
The Pontificia Universidad Catolica de Chile, through its Addiction Studies Center (CEDA UC) and its Department of Family Medicine, is working in conjunction with SENDA (Servicio Nacional para la Prevención y Rehabilitación del Consumo de Drogas y Alcohol ) to design, implement and evaluate a communal system for early detection, brief intervention and referral to treatment (SBIRT), in people older than 18 years, with substance consumption in five municipalities in the country.
The aid of this study is to demonstrate that a model of brief intervention is more effective than the approach currently used in patients with substance use at moderate risk (i.e.follow-up). It is a multicentric randomized controlled trial, single blind, with a group to receive brief intervention and a control group that is kept in control and waiting list being re-evaluated three months later.
The target population is composed by users whose ASSIST screening scores place them in the moderate risk group, for which there has not been defined a structured intervention yet by our health system. The information will be obtained from the scores obtained after the application of the ASSIST-WHO questionnaire.
Detailed Description
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Conditions
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Keywords
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Study Design
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RANDOMIZED
PARALLEL
PREVENTION
SINGLE
Study Groups
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Control group
Observation
Subjects who obtain a moderate risk score in the ASSIST screening questionnaire and after randomization are selected for the control group, will receive a brochure with substance-abuse information without any further conversation about the subject with the caregiver. This observation group will be re-evaluated after 3 months with the same ASSIST screening instrument.
Intervention group
ASSIST-linked brief intervention for hazardous and harmful substance use.
ASSIST-linked brief intervention will be applied to users achieving moderate risk scores in the ASSIST questionnaire. If after randomization are selected to enter the intervention group, they will receive a ten minute counseling carried immediately after the screening instrument. This intervention group will be re-evaluated after 3 months with the same ASSIST screening instrument.
Interventions
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ASSIST-linked brief intervention for hazardous and harmful substance use.
ASSIST-linked brief intervention will be applied to users achieving moderate risk scores in the ASSIST questionnaire. If after randomization are selected to enter the intervention group, they will receive a ten minute counseling carried immediately after the screening instrument. This intervention group will be re-evaluated after 3 months with the same ASSIST screening instrument.
Observation
Subjects who obtain a moderate risk score in the ASSIST screening questionnaire and after randomization are selected for the control group, will receive a brochure with substance-abuse information without any further conversation about the subject with the caregiver. This observation group will be re-evaluated after 3 months with the same ASSIST screening instrument.
Eligibility Criteria
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Inclusion Criteria
* Achieving a moderate risk score in the ASSIST screening questionnaire.
* Without any similar intervention in the last 3 months. (ie. AUDIT test).
Exclusion Criteria
* Users with cognitive disabilities.
* Users with language and communication disabilities.
18 Years
50 Years
ALL
Yes
Sponsors
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Servicio Nacional para la Prevención y Rehabilitación del Consumo de Drogas y Alcohol (SENDA)
UNKNOWN
Pontificia Universidad Catolica de Chile
OTHER
Responsible Party
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Fernando Poblete Arrué
Profesor Asistente Adjunto
Principal Investigators
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Fernando Poblete, MD, MPH
Role: STUDY_DIRECTOR
Pontificia Universidad Catolica de Chile
Locations
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CESFAM Dr. Sergio Aguilar
Coquimbo, IV, Chile
CESFAM San Juan
Coquimbo, IV, Chile
CESFAM Santa Cecilia
Coquimbo, IV, Chile
CESFAM Tierras Blancas
Coquimbo, IV, Chile
SAPU Dr. Sergio Aguilar
Coquimbo, IV, Chile
SAPU Tierras Blancas
Coquimbo, IV, Chile
5ta. Comisaría Conchalí
Conchalí, RM, Chile
CS Alberto Bachelet
Conchalí, RM, Chile
CS José Symon Ojeda
Conchalí, RM, Chile
CS Juanita Aguirre
Conchalí, RM, Chile
CS Lucas Sierra
Conchalí, RM, Chile
SAPU Lucas Sierra
Conchalí, RM, Chile
43va. Comisaría Peñalolén
Peñalolén, RM, Chile
CESFAM Lo Hermida
Peñalolén, RM, Chile
CESFAM Padre Gerardo Whelan
Peñalolén, RM, Chile
CS Carol Urzúa Ibañez
Peñalolén, RM, Chile
CS La Faena
Peñalolén, RM, Chile
SAPU Lo Hermida
Peñalolén, RM, Chile
26va. Comisaría Pudahuel
Pudahuel, RM, Chile
CESFAM Gustavo Molina
Pudahuel, RM, Chile
CESFAM RAúl Silva Henríquez
Pudahuel, RM, Chile
CESFAM Violeta Parra
Pudahuel, RM, Chile
Consultorio Estrella
Pudahuel, RM, Chile
SAPU La Estrella
Pudahuel, RM, Chile
14va. Comisaría San Bernardo
San Bernardo, RM, Chile
APS Carol Urzúa
San Bernardo, RM, Chile
APS Confraternidad
San Bernardo, RM, Chile
APS El Manzano
San Bernardo, RM, Chile
APS Raúl Cuevas
San Bernardo, RM, Chile
SAPU Raúl Brañes
San Bernardo, RM, Chile
Countries
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References
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Humeniuk R, Ali R, Babor T, Souza-Formigoni ML, de Lacerda RB, Ling W, McRee B, Newcombe D, Pal H, Poznyak V, Simon S, Vendetti J. A randomized controlled trial of a brief intervention for illicit drugs linked to the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in clients recruited from primary health-care settings in four countries. Addiction. 2012 May;107(5):957-66. doi: 10.1111/j.1360-0443.2011.03740.x. Epub 2012 Feb 28.
Beich A, Thorsen T, Rollnick S. Screening in brief intervention trials targeting excessive drinkers in general practice: systematic review and meta-analysis. BMJ. 2003 Sep 6;327(7414):536-42. doi: 10.1136/bmj.327.7414.536.
Ballesteros J, Duffy JC, Querejeta I, Arino J, Gonzalez-Pinto A. Efficacy of brief interventions for hazardous drinkers in primary care: systematic review and meta-analyses. Alcohol Clin Exp Res. 2004 Apr;28(4):608-18. doi: 10.1097/01.alc.0000122106.84718.67.
Hungerford DW, Pollock DA, Todd KH. Acceptability of emergency department-based screening and brief intervention for alcohol problems. Acad Emerg Med. 2000 Dec;7(12):1383-92. doi: 10.1111/j.1553-2712.2000.tb00496.x.
Anderson PA, Grey SF, Nichols C, Parran TV Jr, Graham AV. Is screening and brief advice for problem drinkers by clergy feasible? A survey of clergy. J Drug Educ. 2004;34(1):33-40. doi: 10.2190/3QH2-VLWN-ELWM-KC67.
Babor TF, McRee BG, Kassebaum PA, Grimaldi PL, Ahmed K, Bray J. Screening, Brief Intervention, and Referral to Treatment (SBIRT): toward a public health approach to the management of substance abuse. Subst Abus. 2007;28(3):7-30. doi: 10.1300/J465v28n03_03.
Gentilello LM, Rivara FP, Donovan DM, Jurkovich GJ, Daranciang E, Dunn CW, Villaveces A, Copass M, Ries RR. Alcohol interventions in a trauma center as a means of reducing the risk of injury recurrence. Ann Surg. 1999 Oct;230(4):473-80; discussion 480-3. doi: 10.1097/00000658-199910000-00003.
Babor TF, Kadden RM. Screening and interventions for alcohol and drug problems in medical settings: what works? J Trauma. 2005 Sep;59(3 Suppl):S80-7; discussion S94-100. doi: 10.1097/01.ta.0000174664.88603.21.
WHO ASSIST Working Group. The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): development, reliability and feasibility. Addiction. 2002 Sep;97(9):1183-94. doi: 10.1046/j.1360-0443.2002.00185.x.
Whitlock EP, Polen MR, Green CA, Orleans T, Klein J; U.S. Preventive Services Task Force. Behavioral counseling interventions in primary care to reduce risky/harmful alcohol use by adults: a summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2004 Apr 6;140(7):557-68. doi: 10.7326/0003-4819-140-7-200404060-00017.
Hawks D. Broadening the base of treatment for alcohol problems: a report which deserves to be debated. The limits of treatment and importance of prevention. Br J Addict. 1991 Jul;86(7):848-9. doi: 10.1111/j.1360-0443.1991.tb01836.x. No abstract available.
Greene MC, Kane J, Alto M, Giusto A, Lovero K, Stockton M, McClendon J, Nicholson T, Wainberg ML, Johnson RM, Tol WA. Psychosocial and pharmacologic interventions to reduce harmful alcohol use in low- and middle-income countries. Cochrane Database Syst Rev. 2023 May 9;5(5):CD013350. doi: 10.1002/14651858.CD013350.pub2.
Related Links
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Pontificia Universidad Católica de Chile, School of Medicine
Servicio Nacional para la Prevención y Rehabilitación del Consumo de Drogas y Alcohol (SENDA)
Family Medicine Dept., Pontificia Universidad Católica de Chile, School of Medicine.
Other Identifiers
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CEDAUC-11-205
Identifier Type: -
Identifier Source: org_study_id