PMH58 NEW DISEASE MANAGEMENT PROGRAM FOR OPIOID DEPENDENT PATIENTS DECREASES DRUG USE AND INCREASES 12 STEP MEETING ATTENDANCE: ONE YEAR RESULTS OF A RANDOMIZED CLINICAL TRIAL

Abstract

Buprenorphine-medication assisted treatment (B-MAT) is clinically effective for opioid dependence (OD). Ancillary treatment services, however, may be needed to maximize treatment efficacy. The purpose of the present study was to investigate the one year effect of a disease management program on treatment outcomes among a national sample of OD patients. Opioid dependent patients new to B-MAT (N=1.426) were randomized to receive either B-MAT plus a patient support program (intervention group, n = 987) or B-MAT alone (standard care group, n = 439). The intervention was a confidential, outbound, telephonic support program designed to provide new B-MAT patients encouragement and help them resolve problems inherent to early B-MAT treatment. Once enrolled in the study, all patients completed the Addiction Severity Index (ASI) and Treatment Services Review (TSR) at various time points over one year. The ASI is a semi structured interview designed to measure problem severity in seven functional areas known to be affected by alcohol and drug dependence. The TSR assess utilization of a variety of health, social, legal, employment, and family support services. Logistic regression analyses controlling for baseline problem severity and demographics revealed that intervention group subjects were significantly less likely to abuse opioids at month 12 (p < .05; exp (β) = 1.50), and were significantly more likely to attend 12 step/self-help group meetings for substance abuse (p < .05; exp (β) = 0.71) compared to the standard care group. Randomization to the disease management program resulted in a decrease in the reported use of opioids and an increase in self-help group counseling attendance. Supplementing B-MAT with a structured disease management program seems to be an effective way to improve patient outcomes. Current results replicate, and extend to B-MAT, findings from other studies of the effect of telephonic intervention programs on patient outcomes.