Design of CLARO (Collaboration Leading to Addiction Treatment and Recovery from other Stresses): A randomized trial of collaborative care for opioid use disorder and co-occurring depression and/or posttraumatic stress disorder.

Autor: Meredith LS; RAND Corporation, 1776 Main Street, Santa Monica, CA 90407-2138, USA; VA HSR&D Center for Healthcare Innovation, Implementation & Policy, Sepulveda, CA, USA. Electronic address: lisa_meredith@rand.org., Komaromy MS; Grayken Center for Addiction, Boston Medical Center, Boston, MA 02118, USA., Cefalu M; RAND Corporation, 1776 Main Street, Santa Monica, CA 90407-2138, USA., Murray-Krezan C; University of New Mexico School of Medicine, Albuquerque, NM 87131, USA., Page K; University of New Mexico School of Medicine, Albuquerque, NM 87131, USA., Osilla KC; RAND Corporation, 1776 Main Street, Santa Monica, CA 90407-2138, USA., Dopp AR; RAND Corporation, 1776 Main Street, Santa Monica, CA 90407-2138, USA., Leamon I; RAND Corporation, 1776 Main Street, Santa Monica, CA 90407-2138, USA., Tarhuni L; University of New Mexico School of Medicine, Albuquerque, NM 87131, USA., Hindmarch G; RAND Corporation, 1776 Main Street, Santa Monica, CA 90407-2138, USA., Jacobsohn V; First Choice Community Healthcare, 2001 North Centro Familiar, Albuquerque, NM 87105, USA., Watkins KE; RAND Corporation, 1776 Main Street, Santa Monica, CA 90407-2138, USA.
Jazyk: angličtina
Zdroj: Contemporary clinical trials [Contemp Clin Trials] 2021 May; Vol. 104, pp. 106354. Date of Electronic Publication: 2021 Mar 10.
DOI: 10.1016/j.cct.2021.106354
Abstrakt: Introduction: Opioid use disorder (OUD) co-occurring with depression and/or posttraumatic stress disorder (PTSD) is common and, if untreated, may lead to devastating consequences. Despite the availability of evidence-based treatments for these disorders, receipt of treatment is low. Even when treatment is provided, quality is variable. Primary care is an important and underutilized setting for treating co-occurring disorders (COD) because OUD, depression and PTSD are frequently co-morbid with medical conditions and most people visit a primary care provider at least once a year. With rising rates of OUD and opioid-related fatalities, this is a critical treatment and quality gap in a vulnerable and stigmatized population.
Methods: CLARO (Collaboration Leading to Addiction Treatment and Recovery from Other Stresses) is a multi-site, randomized pragmatic trial of collaborative care (CC) for co-occurring disorders in 13 rural and urban primary care clinics in New Mexico to improve care for patients with OUD and co-occurring depression and/or PTSD. CC, a service delivery approach that uses multi-faceted interventions, has not been tested with COD. We will enroll and randomize 900 patients to either CC adapted for COD (CC-COD) or enhanced usual care (EUC) and will collect patient data at baseline, 3-, and 6-month follow-up. Our primary outcomes are medications for OUD (MOUD) access, MOUD continuity of care, depression symptoms, and PTSD symptoms.
Discussion: Although CC is effective for improving outcomes in primary care among patients with mental health conditions, it has not been tested for COD. This article describes the CLARO CC-COD intervention and clinical trial.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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