Who benefits from extended continuing care for cocaine dependence?
| Autor: | Michelle L. Drapkin, Mark S. Cary, James R. McKay, Kevin G. Lynch, Megan Ivey, Deborah H.A. Van Horn, Donna M. Coviello |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
Counseling Male medicine.medical_specialty media_common.quotation_subject Medicine (miscellaneous) Toxicology Article Cocaine dependence Cocaine-Related Disorders Cocaine Ambulatory care Recurrence Internal medicine Ambulatory Care Humans Medicine Psychiatry Depression (differential diagnoses) media_common Motivation Intensive outpatient program Continuing care business.industry Attendance Middle Aged Abstinence medicine.disease Long-Term Care Telephone Substance Abuse Detection Psychiatry and Mental health Clinical Psychology Long-term care Treatment Outcome Psychotherapy Group Patient Compliance Female business |
| Zdroj: | Addictive Behaviors. 39:660-668 |
| ISSN: | 0306-4603 |
| DOI: | 10.1016/j.addbeh.2013.11.019 |
| Popis: | The goal of this study was to determine which cocaine dependent patients engaged in an intensive outpatient program (IOP) were most likely to benefit from extended continuing care (24 months). Participants (N=321) were randomized to: IOP treatment as usual (TAU), TAU plus Telephone Monitoring and Counseling (TMC), or TAU plus TMC plus incentives for session attendance (TMC+). Potential moderators examined were gender, stay in a controlled environment prior to IOP, number of prior drug treatments, and seven measures of progress toward IOP goals. Outcomes were: (1) abstinence from all drugs and heavy alcohol use, and (2) cocaine urine toxicology. Follow-ups were conducted at 3, 6, 9, 12, 18, and 24 months post-baseline. Results indicated that there were significant effects favoring TMC+ over TAU on the cocaine urine toxicology outcome for participants in a controlled environment prior to IOP and for those with no days of depression early in IOP. Trends were obtained favoring TMC over TAU for those in a controlled environment (cocaine urine toxicology outcome) or with high family/social problem severity (abstinence composite outcome), and TMC+ over TAU for those with high family/social problem severity or high self-efficacy (cocaine urine toxicology outcome). None of the other potential moderator effects examined reached the level of a trend. These results generally do not suggest that patients with greater problem severity or poorer performance early in treatment on the measures considered in this report will benefit to a greater degree from extended continuing care. |
| Databáze: | OpenAIRE |
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