Evidence map›Paper›PMID 32166232›Full record

ArticleCritical care explorations2019

Pilot Randomized Trial of a Recovery Navigator Program for Survivors of Critical Illness With Problematic Alcohol Use.

Brendan J Clark, Tanya Sorrell, Rachel M Hodapp, Kathryne Reed, Marc Moss, Laurra Aagaard, Paul F Cook

Open access · goldAbstract read
In one paragraph

Article in Critical care explorations, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact, top 85% 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

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Article
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.

Brendan J ClarkDepartment of Medicine, University of Colorado School of Medicine, Aurora, CO.
Tanya SorrellBiobehavioral Symptom Science Group, University of Colorado College of Nursing, Aurora, CO.
Rachel M HodappDepartment of Medicine, University of Colorado School of Medicine, Aurora, CO.
Kathryne ReedDepartment of Medicine, University of Colorado School of Medicine, Aurora, CO.
Marc MossDepartment of Medicine, University of Colorado School of Medicine, Aurora, CO.
Laurra AagaardBiobehavioral Symptom Science Group, University of Colorado College of Nursing, Aurora, CO.
Paul F CookBiobehavioral Symptom Science Group, University of Colorado College of Nursing, Aurora, CO.
University of Colorado Denver · US

Funding

CTSA INFRASTRUCTURE FOR PEDIATRIC RESEARCHUL1RR025780 · NCRR · UNIVERSITY OF COLORADO DENVER · PI SOKOL, RONALD J. · 2008 to 2011
$61.3M
Tailored Screening, Brief Intervention, and Referral to Treatment for Medical IntK23AA021814 · NIAAA · UNIVERSITY OF COLORADO DENVER · PI CLARK, BRENDAN JAMES · 2014 to 2017
$688k
NCRR NIH HHS UL1 RR025780NIAAA NIH HHS K23 AA021814
6 · The paper itself

Abstract

Many survivors of critical illness have problematic alcohol use, associated with risk of death and hospital readmission. We tested the feasibility, acceptability, treatment fidelity, and potential efficacy of a customized alcohol intervention for patients in ICUs. The intervention was delivered by a Recovery Navigator using principles of motivational interviewing and shared decision-making.

designPilot randomized trial.

settingTwo urban ICUs in Denver, CO. PATIENTS: Patients with problematic alcohol use were enrolled prior to hospital discharge.

interventionsPatients were randomly assigned to usual care, single-session motivational interviewing and shared decision-making, or multisession motivational interviewing and shared decision-making. MEASUREMENTS AND MAIN

resultsWe assessed feasibility via enrollment and attrition, acceptability via patient satisfaction (Client Satisfaction Questionnaire-8), fidelity via observation and questionnaires, and potential efficacy via group means and CIs on measures of alcohol use, psychiatric symptoms, cognition, and other alcohol-related problems. Over 18 months, we offered the study to 111 patients, enrolled 47, and randomized 36; refusals were mainly due to stigma or patients' desire to handle problems on their own. Groups were similar at baseline, and 67% of patients met criteria for alcohol use disorder. Average patient satisfaction was high (mean = 28/32) regardless of group assignment. Sessions were delivered with 98% adherence to motivational interviewing principles and excellent motivational interviewing spirit; patients perceived the intervention to be more autonomy supportive than usual care. Group means after 6 months suggested that patients receiving the intervention might improve on measures such as alcohol use, psychiatric symptoms, legal problems, and days of paid work; however, they did not receive more substance use treatment. All results were nonsignificant due to small sample size.

conclusionsA Recovery Navigator intervention was feasible and acceptable for delivering high-fidelity brief interventions to ICU patients. Changes in alcohol-related problems with motivational interviewing and shared decision-making were nonsignificant but clinically meaningful in size. A full-scale randomized trial of motivational interviewing and shared decision-making is warranted.

Indexed as

alcoholcritical illnessdecision-makingintensive care unitmotivational interviewingnavigation

Identifiers

PMID32166232
PMCPMC7063892
OpenAlexW2980505779

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.