Disclosing Recovery: A pilot randomized controlled trial of a patient decision aid to improve disclosure processes for people in treatment for opioid use disorder.

Autor: Earnshaw VA; Department of Human Development and Family Sciences, University of Delaware, 111 Alison Hall West, Newark, DE 19716, USA. Electronic address: earnshaw@udel.edu., Sepucha KR; Health Decision Sciences Center, Massachusetts General Hospital, 100 Cambridge St, Suite 1600, Boston, MA 02114, USA; Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA. Electronic address: KSEPUCHA@mgh.harvard.edu., Laurenceau JP; Department of Psychological and Brain Sciences, University of Delaware, 231 Wolf Hall, Newark, DE 19716, USA. Electronic address: jlaurenc@udel.edu., Subramanian SV; Harvard Center for Population and Development Studies, Cambridge, MA, USA; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA. Electronic address: svsubram@hsph.harvard.edu., Hill EC; Department of Human Development and Family Sciences, University of Delaware, 111 Alison Hall West, Newark, DE 19716, USA; Center for Research on Education and Social Policy, University of Delaware, 125 Academy Street, Newark, DE 19716, USA. Electronic address: ehill@udel.edu., Wallace J; Center for Research on Education and Social Policy, University of Delaware, 125 Academy Street, Newark, DE 19716, USA; Department of Epidemiology, University of Delaware, 100 Discovery Blvd, Newark, DE 19716, USA. Electronic address: jawall@udel.edu., Brousseau NM; Graduate School of Applied and Professional Psychology, Rutgers University, 152 Frelinghuysen Rd, Piscataway, NJ 08854-8020, USA. Electronic address: nbrousseauu@gmail.com., Henderson C; Health Services and Population Research Department, King's College London Institute of Psychiatry, Psychology and Neuroscience, United Kingdom of Great Britain and Northern Ireland. Electronic address: Claire.1.Henderson@kcl.ac.uk., Brohan E; Health Services and Population Research Department, King's College London Institute of Psychiatry, Psychology and Neuroscience, United Kingdom of Great Britain and Northern Ireland. Electronic address: elaine.brohan@kcl.ac.uk., Morrison LM; Brandywine Counseling and Community Services, 2713 Lancaster Avenue, Wilmington, DE 19805, USA. Electronic address: lmorrison@brandywinecounseling.org., Kelly JF; Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA; Recovery Research Institute, Massachusetts General Hospital, 151 Merrimac St, 6th Floor, Boston, MA 02114, USA. Electronic address: JKELLY11@mgh.harvard.edu.
Jazyk: angličtina
Zdroj: Journal of substance use and addiction treatment [J Subst Use Addict Treat] 2024 May; Vol. 160, pp. 209291. Date of Electronic Publication: 2024 Jan 23.
DOI: 10.1016/j.josat.2024.209291
Abstrakt: Introduction: People engaged in treatment for opioid use disorder (OUD) report struggling with whether and how to disclose, or share information about their OUD history and/or treatment with others. Yet, disclosure can act as a gateway to re-establishing social connection and support during recovery. The current study describes a pilot randomized controlled trial of Disclosing Recovery: A Decision Aid and Toolkit, a patient decision aid designed to facilitate disclosure decisions and build disclosure skills.
Methods: Participants (n = 50) were recruited from a community-based behavioral health organization in 2021-2022 and randomized to receive the Disclosing Recovery intervention versus an attention-control comparator. They responded to surveys immediately after receiving the intervention as well as one month following the intervention at a follow-up appointment. Primary outcome analyses examined indicators of implementation of the intervention to inform a future efficacy trial. Secondary outcome analyses explored impacts of the intervention on the decision-making process, disclosure rates, and relationships.
Results: Participants were successfully recruited, randomized, and retained, increasing confidence in the feasibility of future efficacy trials to test the Disclosing Recovery intervention. Moreover, participants in the Disclosing Recovery intervention agreed that the intervention is acceptable, feasible, and appropriate. They additionally reported a higher quality of their decision-making process and decisions than participants in the comparator condition. At their follow-up appointment, participants with illicit opioid use who received the Disclosing Recovery intervention were less likely to disclose than those who received the comparator condition. Moreover, significant interactions between illicit opioid use and the intervention condition indicated that participants without illicit opioid use who received the Disclosing Recovery intervention reported greater closeness to and social support from their planned disclosure recipient than those who received the comparator condition.
Conclusions: The Disclosing Recovery intervention appears to be an acceptable, feasible, and appropriate patient decision aid for addressing disclosure processes among people in treatment for OUD. Moreover, preliminary results suggest that it shows promise in improving relationship closeness and social support in patients without illicit opioid use. More testing is merited to determine the intervention's efficacy and effectiveness in improving relationship and treatment outcomes for people in treatment for OUD.
Competing Interests: Declaration of competing interest The authors do not have conflicts of interest to report. The authors do not have a financial interest in the decision aid itself.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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