Katherine E Watkins1, Allison Ober2, Colleen McCullough3, Claude Setodji4, Karen Lamp5, Mimi Lind6, Sarah B Hunter7, Karen Chan Osilla8. 1. RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407, USA. Electronic address: kwatkins@rand.org. 2. RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407, USA. Electronic address: ober@rand.org. 3. RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407, USA. Electronic address: cmccullo@rand.org. 4. RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA, 15213, USA. Electronic address: setodji@rand.org. 5. Venice Family Clinic, 604 Rose Avenue, Venice, CA, 90291, USA. Electronic address: KLamp@mednet.ucla.edu. 6. Venice Family Clinic, 604 Rose Avenue, Venice, CA, 90291, USA. Electronic address: MLind@mednet.ucla.edu. 7. RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407, USA. Electronic address: shunter@rand.org. 8. RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407, USA. Electronic address: karenc@rand.org.
Abstract
BACKGROUND: We identified predictors of receiving treatment (brief therapy [BT] and/or extended-release injectable naltrexone [XR-NTX]) for the treatment of alcohol use disorders (AUDs) in primary care. We also examined the relationship between receiving BT and XR-NTX. METHODS: Secondary data analysis of SUMMIT, a randomized controlled trial of collaborative care. Participants were 290 individuals with AUDs who reported no past 30-day opioid use and who were receiving primary care at a multi-site Federally Qualified Health Center. Bivariate and multivariate analyses examined predictors of BT and/or XR-NTX. RESULTS: Thirty-two percent (N = 93) received either BT or XR-NTX, 28% (N = 82) received BT and 13% (N = 37) received XR-NTX; 9% (N = 26) received both BT and XR-NTX. Older age, white race, talking with a professional about alcohol use and having more negative consequences all predicted receipt of evidence-based treatment; being homeless was a negative predictor. The predictors of receiving BT included not being homeless and previously talking with a professional; the predictors of receiving XR-NTX included older age, white race and experiencing more negative consequences. In 80% of those who received both BT and XR-NTX, receipt of BT preceded XR-NTX. CONCLUSIONS: Patient factors were important predictors of receiving primary-care based AUD treatment and differed by type of treatment received. Receiving BT was associated with subsequent use of XR-NTX and may be associated with a longer duration of XR-NTX treatment. Providers should consider these findings when considering ways to increase primary-care based AUD treatment.
RCT Entities:
BACKGROUND: We identified predictors of receiving treatment (brief therapy [BT] and/or extended-release injectable naltrexone [XR-NTX]) for the treatment of alcohol use disorders (AUDs) in primary care. We also examined the relationship between receiving BT and XR-NTX. METHODS: Secondary data analysis of SUMMIT, a randomized controlled trial of collaborative care. Participants were 290 individuals with AUDs who reported no past 30-day opioid use and who were receiving primary care at a multi-site Federally Qualified Health Center. Bivariate and multivariate analyses examined predictors of BT and/or XR-NTX. RESULTS: Thirty-two percent (N = 93) received either BT or XR-NTX, 28% (N = 82) received BT and 13% (N = 37) received XR-NTX; 9% (N = 26) received both BT and XR-NTX. Older age, white race, talking with a professional about alcohol use and having more negative consequences all predicted receipt of evidence-based treatment; being homeless was a negative predictor. The predictors of receiving BT included not being homeless and previously talking with a professional; the predictors of receiving XR-NTX included older age, white race and experiencing more negative consequences. In 80% of those who received both BT and XR-NTX, receipt of BT preceded XR-NTX. CONCLUSIONS:Patient factors were important predictors of receiving primary-care based AUD treatment and differed by type of treatment received. Receiving BT was associated with subsequent use of XR-NTX and may be associated with a longer duration of XR-NTX treatment. Providers should consider these findings when considering ways to increase primary-care based AUD treatment.
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