Evidence map›Paper›PMID 30223190›Full record

Trial reportDrug and alcohol dependence2018

Initiation and engagement as mechanisms for change caused by collaborative care in opioid and alcohol use disorders.

Claude M Setodji, Katherine E Watkins, Sarah B Hunter, Colleen McCullough, Bradley D Stein, Karen Chan Osilla, Allison J Ober

Open access · greenAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Drug and alcohol dependence, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.

  1. Pooled it
  2. Trial
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  6. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Claude M SetodjiRAND Corporation, 4570, 5th Avenue, Suite 600, Pittsburgh, PA, 15213-2665, USA. Electronic address: setodji@rand.org.
Katherine E WatkinsRAND Corporation, 1776 Main Street, Santa Monica, CA, 90407-2138, USA. Electronic address: kwatkins@rand.org.
Sarah B HunterRAND Corporation, 1776 Main Street, Santa Monica, CA, 90407-2138, USA. Electronic address: shunter@rand.org.
Colleen McCulloughRAND Corporation, 1776 Main Street, Santa Monica, CA, 90407-2138, USA. Electronic address: Colleen_McCullough@rand.org.
Bradley D SteinRAND Corporation, 4570, 5th Avenue, Suite 600, Pittsburgh, PA, 15213-2665, USA. Electronic address: Bradley_Stein@rand.org.
Karen Chan OsillaRAND Corporation, 1776 Main Street, Santa Monica, CA, 90407-2138, USA. Electronic address: karenc@rand.org.
Allison J OberRAND Corporation, 1776 Main Street, Santa Monica, CA, 90407-2138, USA. Electronic address: ober@rand.org.
RAND Corporation · US

Funding

Integrated Collaborative Care for Substance Use DisordersR01DA034266 · NIDA · RAND CORPORATION · PI WATKINS, KATHERINE E · 2012 to 2016
$4.0M
NIDA NIH HHS R01 DA034266
6 · The paper itself

Abstract

backgroundTo assess the mechanism by which a collaborative care (CC) intervention improves self-reported abstinence among primary care patients with opioid and alcohol use disorders (OAUD) compared to treatment as usual.

methodsSecondary data analysis of SUMMIT, a randomized controlled trial of CC for OAUD. Participants were 258 patients with OAUD receiving primary care at a multi-site Federally Qualified Health Center. Using a mediation analysis decomposition of a total effect into a mediated and a direct effect, we examined the effect of CC on abstinence at six months, attributable to the HEDIS treatment initiation and engagement measures for the total sample, for individuals with alcohol use disorders alone, and for those with a co-morbid opioid use disorder.

resultsAlthough the CC intervention led to an increase in both initiation and engagement, among the full sample, only initiation mediated the effect of the intervention on abstinence (3.8%, CI=[0.4%, 8.3%]; 32% proportion of the total effect). In subgroup analyses, among individuals with comorbid alcohol and opioid use disorders, almost 100% of the total effect was mediated by engagement, but the effect was not significant. This was not observed among the alcohol use disorder only group.

conclusionsAmong primary care patients with OAUDs, treatment initiation partially mediated the effect of CC on abstinence at 6-months. The current study emphasizes the importance of primary care patients returning for a second substance-use related visit after identification. CC may work differently for people with co-morbid opioid use disorders vs. alcohol use disorders alone.

Indexed as

AdultAlcoholismAnalgesics, OpioidFemaleFollow-Up StudiesHumansIntersectoral CollaborationMaleMiddle AgedOpioid-Related DisordersPatient ParticipationPrimary Health CareSelf ReportSocial BehaviorAnalgesics, OpioidCollaborative care interventionEngagementMediationOpioid and alcohol use disordersTreatment initiation

Identifiers

PMID30223190
PMCPMC6334843
OpenAlexW2891030709

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.