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Talal AH, George SJ, Talal LA, Dharia A, Ventuneac A, Baciewicz G, Perumalswami PV, Dickerson SS. Engaging people who use drugs in clinical research: integrating facilitated telemedicine for HCV into substance use treatment. Res Involv Engagem 2023; 9:63. [PMID: 37533127 PMCID: PMC10399008 DOI: 10.1186/s40900-023-00474-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 07/20/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND People who use drugs (PWUD) have difficulty participating in clinical research. We evaluated approaches to engage PWUD in clinical research, using facilitated telemedicine for hepatitis C virus (HCV) care as an example. METHODS We analyzed stakeholder interview transcripts and study-related data (i.e., progress reports, meeting minutes) from interrelated studies to understand engagement experiences at the patient, site, and organizational levels. Stakeholders include patient-participants, opioid treatment program (OTP) staff and administrators, and research team members involved in HCV management through facilitated telemedicine integrated into OTPs. RESULTS Three themes emerged. Initially, the research team sought understanding of the unique culture and community of each OTP (Theme 1). The team built trusting relationships through education, communication, and feedback (Theme 2). Finally, the research team enhanced collaborative care and incorporated the patients' voice to improve health outcomes (Theme 3). Patient-participants and OTP staff endorsed the integrated HCV care approach. Engagement practices are summarized as the CREATE framework (C = culture, R = respect, E = educate, A = advantage, T = trust, E = endorse). CONCLUSIONS PWUD engagement in clinical research is maximized by building trusting relationships with open communication channels. Understanding the community, demonstrating respect, and augmenting knowledge are foundational for engaging PWUD in clinical research. These practices are transferable to engagement of PWUD in clinical research broadly.
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Affiliation(s)
- Andrew H Talal
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, University at Buffalo, State University of New York, 875 Ellicott Street, Suite 6090, Buffalo, NY, 14203, USA.
| | - Saliyah J George
- Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Arpan Dharia
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, University at Buffalo, State University of New York, 875 Ellicott Street, Suite 6090, Buffalo, NY, 14203, USA
| | - Ana Ventuneac
- START Treatment and Recovery Centers, Brooklyn, NY, USA
| | | | - Ponni V Perumalswami
- Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Suzanne S Dickerson
- Division of Biobehavioral Health and Clinical Sciences, School of Nursing, University at Buffalo, Buffalo, NY, USA
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Ashrafioun L, Gamble S, Herrmann M, Baciewicz G. Evaluation of knowledge and confidence following opioid overdose prevention training: A comparison of types of training participants and naloxone administration methods. Subst Abus 2015; 37:76-81. [DOI: 10.1080/08897077.2015.1110550] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Conner KR, Ross ME, Baciewicz G, Sworts LM, Meldrum SC. Reliability of the Lifetime Inventory of Drug Use Consequences (INDUC) in methadone maintenance patients. J Psychoactive Drugs 2009; 41:93-8. [PMID: 19455913 DOI: 10.1080/02791072.2009.10400678] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
One hundred twenty one opiate-dependent individuals in methadone maintenance treatment at an urban university medical center in the U.S. were administered the Inventory of Drug Use Consequences (InDUC), and 68 subjects provided follow-up assessments at two to six weeks. The sample included 61 (50.4%) women; 86 (71.1%) of the subjects reported that they were White, 29 (24.0%) Black, and six (5.0%) other race. The mean age was 41.9 (SD = 9.7) years. Ninety-nine (81.8%) of participants had used opiates intravenously. INDUC total scores and a short form showed high internal consistency (alpha) and test-retest reliability (ICC) across gender, race, ethnicity, and education, supporting their use as global measures of drug use consequences. The interpersonal scale was also reliable across strata whereas the physical and intrapersonal scales were not reliable. The impulse control and social responsibility scales were stable but not internally consistent.
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Affiliation(s)
- Kenneth R Conner
- Center for the Study and Prevention of Suicide, Department of Psychiatry, University of Rochester Medical Center, 300 Crittenden Blvd, Rochester, NY 14642, USA.
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Landau J, Stanton MD, Brinkman-Sull D, Ikle D, McCormick D, Garrett J, Baciewicz G, Shea RR, Browning A, Wamboldt F. Outcomes with the ARISE approach to engaging reluctant drug- and alcohol-dependent individuals in treatment. Am J Drug Alcohol Abuse 2005; 30:711-48. [PMID: 15624546 DOI: 10.1081/ada-200037533] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Our goal was to explore, through a Stage I NIH clinical study, the effectiveness of a manual-driven, timely response method for helping the "concerned other" get resistant substance abusers into treatment/self-help with minimum professional time/effort. A manual-driven protocol, "A Relational Sequence for Engagement (ARISE)," was applied with 110 consecutive, initial calls/contacts from concerned others; no cases excluded for research, refusal, or other reasons. The research was conducted at two upstate New York outpatient drug/alcohol clinics. Participants were concerned others who called regarding a cocaine, alcohol, or "other drug" abuser (N = 110); participating family/friends: 11 ARISE clinicians; and 110 substance abusers. ARISE is a graduated continuum starting with the least demanding option/stage, increasing effort as needed to engage substance abusers in treatment/self-help. Stage I: Coaching the concerned other to arrange a meeting of significant others, inviting the substance abuser; Stage II: 1 to 5 additional meetings (median = 2); Stage III: A modified Johnson "Intervention." Primary outcome variables were substance abuser engagement (or not) in treatment/self-help; days between first call and engagement; clinician time/effort. Predictors were concerned other, substance abuser, and clinician demographics; number of participants per case; and Collateral Addiction Severity Index. ARISE resulted in an 83% success rate (55% at Stage I). Median days to engagement was 7 (IQR = 2 to 14). Average total time (telephone, sessions) per case was 1.5 hours. Treatment/self-help chosen was 95% treatment and 5% self-help. Number of family/ friends involved correlated 0.69 with a success/efficiency index. Conclusions. A call from a family member or concerned other for help in getting a loved one into treatment is a rich opportunity for treatment professionals and agencies to engage substance abusers in treatment. These initial calls are similar to referral calls from EAPs or probation officers looking to get an individual started in treatment. ARISE provides an effective, swift, and cost-efficient option for engaging substance abusers in treatment or self-help. The more significant others involved, the greater the success of treatment engagement.
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Landau J, Garrett J, Shea RR, Stanton MD, Brinkman-Sull D, Baciewicz G. Strength in numbers: the ARISE method for mobilizing family and network to engage substance abusers in treatment. A Relational Intervention Sequence for Engagement. Am J Drug Alcohol Abuse 2000; 26:379-98. [PMID: 10976664 DOI: 10.1081/ada-100100251] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The model described in this paper takes into consideration two key findings: (a) In a given year, the vast majority (90-95%) of active substance abusers do not enter treatment or self-help groups, and (b) substance abusers have frequent contact with their families (60-80% either live with a parent or are in daily contact). This paper presents a method for mobilizing and collaborating with families and extended the support system toward working with resistance and getting the substance abuser into treatment. Principles and techniques are provided for convening and structuring intervention network meetings toward that end. This intervention network approach can be used either alone or as part of an overall model, ARISE (A Relational Intervention Sequence for Engagement). The ARISE model addresses both clinical and programmatic issues in treatment engagement for substance abusers.
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Affiliation(s)
- J Landau
- Linking Human Systems, Boulder, Colorado 80304, USA.
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Garrett J, Stanton MD, Landau J, Baciewicz G, Brinkman-Sull D, Shea R. The "concerned other" call: using family links and networks to overcome resistance to addiction treatment. Subst Use Misuse 1999; 34:363-82. [PMID: 10082062 DOI: 10.3109/10826089909035651] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Untreated chemical dependency costs the United States over $165 billion annually. Meanwhile, treatment offsets these costs by a ratio of $7 saved for every $1 spent. But the vast majority of chemically dependent people (CDPs) remain uninvolved in either treatment or self-help groups. It is therefore imperative that more effective ways be developed for therapeutically engaging them. One avenue is to maximize the opportunity presented when a "concerned other" (CO) person-such as a family member, friend, coworker, or clergy member-contacts a treatment agency to get help for a CDP. This paper provides a method for handling such calls. Specific guidelines are presented as to (a) the kind of information to b e gathered, (b) procedures to be followed, and (c) options to be offered toward mobilizing the CO and other family/social network members in successfully effecting CDP treatment engagement.
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Garrett J, Landau J, Shea R, Stanton MD, Baciewicz G, Brinkman-Sull D. The ARISE Intervention. Using family and network links to engage addicted persons in treatment. J Subst Abuse Treat 1998; 15:333-43. [PMID: 9650142 DOI: 10.1016/s0740-5472(97)00212-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
An alternative method to the Johnson Institute's "Intervention" is presented which, while incorporating many of Johnson's innovations, is, additionally: (a) less confrontative, thereby avoiding the reactivity in clients and family members that such confrontational approaches have tended to evoke; (b) takes into account both the needs of the chemically dependent person as well as the needs of the larger family and network system; and (c) aimed toward enrolling substance abusers in outpatient (as well as inpatient) treatment, thus placing it more in line with managed care priorities. Principles for treatment engagement are presented, accompanied by case examples. The approach is part of a more comprehensive model designed to maximize successful engagement with a minimum amount of professional time and effort.
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Conner KR, Shea RR, McDermott MP, Grolling R, Tocco RV, Baciewicz G. The role of multifamily therapy in promoting retention in treatment of alcohol and cocaine dependence. Am J Addict 1998; 7:61-73. [PMID: 9522008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The authors present a model for incorporating multifamily therapy in the treatment of chemical dependency and investigate the association of family participation in multifamily therapy group with treatment retention in a sample of 164 alcohol- and/or cocaine-dependent outpatients. Results indicate that level of family attendance at a multifamily group strongly predicted completion of short-term and long-term out-patient treatment. Effects were greater for cocaine-dependent than for alcohol-dependent subjects in analyses of short-term treatment retention. Multifamily therapy may be a powerful method to engage patients families in treatment and promote treatment retention, especially in the early, intensive phases of treatment for cocaine dependency.
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Affiliation(s)
- K R Conner
- Department of Psychiatry, University of Rochester Medical Center, New York, NY 14642, USA.
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Conner KR, Shea RR, McDermott MP, Grolling R, Tocco RV, Baciewicz G. The Role of Multifamily Therapy in Promoting Retention in Treatment of Alcohol and Cocaine Dependence. Am J Addict 1998. [DOI: 10.3109/10550499809034713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Conner KR, Shea RR, McDermott MP, Grolling R, Tocco RV, Baciewicz G. The Role of Multifamily Therapy in Promoting Retention in Treatment of Alcohol and Cocaine Dependence. Am J Addict 1998. [DOI: 10.1111/j.1521-0391.1998.tb00468.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Baciewicz G, Yerevanian BI. Thrombocytopenia associated with carbamazepine: case report and review. J Clin Psychiatry 1984; 45:315-6. [PMID: 6735991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
A case of thrombocytopenia associated with carbamazepine use is reported, and previous reports of adverse hematologic effects in patients taking carbamazepine are discussed. With increasing use of carbamazepine in the treatment of affective disorders, psychiatrists will need to be aware of the drug's hematologic side effects, and institute appropriate monitoring procedures.
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Yerevanian BI, Olafsdottir H, Milanese E, Russotto J, Mallon P, Baciewicz G, Sagi E. Normalization of the dexamethasone suppression test at discharge from hospital. Its prognostic value. J Affect Disord 1983; 5:191-7. [PMID: 6224831 DOI: 10.1016/0165-0327(83)90041-1] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Fourteen patients with RDC diagnosis of primary, endogenous, major depressive disorder were studied in an inpatient setting. All were non-suppressors on the Dexamethasone Suppression Test on admission to hospital and were retested at discharge. Over 70% of patients continued to be non-suppressors at discharge, when in clinical remission. Four out of 14 patients converted to normal suppression. All 10 of the non-normalizers did poorly on follow-up: 3 patients committed suicide. All normalizers did well. Non-normalization of the DST at discharge from hospitalization may be more common than previously suspected and predicts poor clinical outcome.
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