Study Results
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View full resultsBasic Information
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COMPLETED
NA
325 participants
INTERVENTIONAL
2021-11-11
2023-12-19
Brief Summary
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Detailed Description
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The Substance Use Treatment and Recovery Team (START) is an intervention that adapts the principles of collaborative care to the hospital setting. Prior studies have demonstrated the effectiveness of collaborative care in outpatient settings for patients with opioid and alcohol use disorders, and a series of reports have demonstrated the feasibility and potential efficacy of hospital based consultative teams for substance use disorders. START uses team based, multi-faceted interventions (ie: motivational interviewing, medication treatment, OUD-focused discharge planning), measurement-based care, and patient registries to increase delivery of evidence-based care. The goal of START is to facilitate initiation of MOUD during the inpatient stay and link patients to appropriate post-discharge care.
The START study is a multi-site, randomized trial that will evaluate the intervention improves MOUD initiation and linkage to follow-up care among hospitalized patients with OUD. A total of 414 patients will be randomized from three geographically diverse hospitals (Cedars-Sinai Medical Center in Los Angeles, the University of New Mexico Hospital in Albuquerque, and Baystate Health in Springfield, Massachusetts) to receive either START or usual care, stratifying by prior MOUD exposure and site. The study builds on a pilot randomized controlled trial conducted at Cedars-Sinai by testing the intervention at three geographically distinct locations, thus increasing generalizability.
If the aims of the research are achieved, the investigators will learn whether this model of care increases OUD treatment delivery in general medical hospitals, and decreases the downstream effects of untreated OUD. If effective, this translational model also can be used to increase uptake of evidence-based practices for other substance use and behavioral health disorders.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
NONE
Study Groups
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Substance Use Treatment and Recovery Team (START)
The intervention is administered to participants in this arm. Participants in this arm will work with the Substance Use Treatment and Recovery Team (START), a collaborative care team for inpatients with opioid use disorder.
Substance Use Treatment and Recovery Team (START)
START is a model of care based on Collaborative Care. START is team driven, population-focused, measurement based, and focused on promoting adoption of evidence-based interventions. The purpose of this model is to increase adoption of evidence-based interventions for opioid use disorder and to increase linkage to aftercare.
The components of the START intervention are as follows:
1. Triage
2. Engage, Assess, and Plan
3. Treat
4. Communicate and Coordinate
5. Follow up
6. Monitor
Usual Care
Usual care for people with opioid use disorder.
No interventions assigned to this group
Interventions
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Substance Use Treatment and Recovery Team (START)
START is a model of care based on Collaborative Care. START is team driven, population-focused, measurement based, and focused on promoting adoption of evidence-based interventions. The purpose of this model is to increase adoption of evidence-based interventions for opioid use disorder and to increase linkage to aftercare.
The components of the START intervention are as follows:
1. Triage
2. Engage, Assess, and Plan
3. Treat
4. Communicate and Coordinate
5. Follow up
6. Monitor
Eligibility Criteria
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Inclusion Criteria
* Age 18 and older
* Have a probable OUD diagnosis, defined by scores of \> 3 on the opioid section of the Alcohol, Smoking, and Substance Involvement Screening test (ASSIST)
* Speaks English or Spanish as primary language
* Willing to participate in follow-up calls and interview by telephone and able to provide contact information for follow-up calls
* Able to provide informed consent
Exclusion Criteria
* \< 6 months life expectancy
18 Years
ALL
No
Sponsors
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RAND
OTHER
University of New Mexico
OTHER
Baystate Health
OTHER
National Center for Advancing Translational Sciences (NCATS)
NIH
National Institute on Drug Abuse (NIDA)
NIH
Stanford University
OTHER
University of Pittsburgh
OTHER
Cedars-Sinai Medical Center
OTHER
Responsible Party
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Itai Danovitch
Professor and Chair Department of Psychiatry & Behavioral Neurosciences
Principal Investigators
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Itai Danovitch, MD
Role: PRINCIPAL_INVESTIGATOR
Cedars-Sinai Medical Center
Allison J Ober, PhD
Role: PRINCIPAL_INVESTIGATOR
RAND
Locations
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Cedars Sinai Medical Center
Los Angeles, California, United States
Baystate Medical Center
Springfield, Massachusetts, United States
University of New Mexico Hospital
Albuquerque, New Mexico, United States
Countries
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References
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Ober AJ, Murray-Krezan C, Page K, Friedmann PD, Anderson J, Osilla KC, Ryzewicz S, Huerta S, Mazer MW, Hoskinson RA, Garvey R, Peltz A, Watkins KE, Nuckols T, IsHak WW, Mariano LT, Danovitch I. Hospital Addiction Consultation Service and Opioid Use Disorder Treatment: The START Randomized Clinical Trial. JAMA Intern Med. 2025 Jun 1;185(6):624-633. doi: 10.1001/jamainternmed.2024.8586.
Ober AJ, Murray-Krezan C, Page K, Friedmann PD, Chan Osilla K, Ryzewicz S, Huerta S, Mazer MW, Leamon I, Messineo G, Watkins KE, Nuckols T, Danovitch I. The Substance Use Treatment and Recovery Team (START) study: protocol for a multi-site randomized controlled trial evaluating an intervention to improve initiation of medication and linkage to post-discharge care for hospitalized patients with opioid use disorder. Addict Sci Clin Pract. 2022 Jul 28;17(1):39. doi: 10.1186/s13722-022-00320-7.
Provided Documents
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Document Type: Study Protocol
Document Type: Statistical Analysis Plan
Document Type: Informed Consent Form
Other Identifiers
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