Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Addiction Science & Clinical Practice
Published in: Addiction Science & Clinical Practice 1/2017

Open Access 01-12-2017 | Study protocol

Mobile technology intervention to improve care coordination between HIV and substance use treatment providers: development, training, and evaluation protocol

Authors: Kasey Claborn, Sara Becker, Susan Ramsey, Josiah Rich, Peter D. Friedmann

Published in: Addiction Science & Clinical Practice | Issue 1/2017

Login to get access

Abstract

Background

People living with HIV (PLWH) with a substance use disorder (SUD) tend to receive inadequate medical care in part because of a siloed healthcare system in which HIV and substance use services are delivered separately. Ideal treatment requires an interdisciplinary, team-based coordinated care approach, but many structural and systemic barriers impede the integration of HIV and SUD services. The current protocol describes the development and preliminary evaluation of a care coordination intervention (CCI), consisting of a tablet-based mobile platform for HIV and SUD treatment providers, an interagency communication protocol, and a training protocol. We hypothesize that HIV and SUD treatment providers will find the CCI to be acceptable, and that after receipt of the CCI, providers will: exhibit higher retention in dual care among patients, report increased frequency and quality of communication, and report increased rates of relational coordination.

Methods/design

A three phase approach is used to refine and evaluate the CCI. Phase 1 consists of in-depth qualitative interviews with 8 key stakeholders as well as clinical audits of participating HIV and SUD treatment agencies. Phase 2 contains functionality testing of the mobile platform with frontline HIV and SUD treatment providers, followed by refinement of the CCI. Phase 3 consists of a pre-, post-test trial with 30 SUD and 30 HIV treatment providers. Data will be collected at the provider, organization, and patient levels. Providers will complete assessments at baseline, immediately post-training, and at 1-, 3-, and 6-months post-training. Organizational data will be collected at baseline, 1-, 3-, and 6-months post training, while patient data will be collected at baseline and 6-months post training.

Discussion

This study will develop and evaluate a CCI consisting of a tablet-based mobile platform for treatment providers, an interagency communication protocol, and a training protocol as a means of improving the integration of care for PLWH who have a SUD. Results have the potential to advance the field by bridging gaps in a fragmented healthcare system, and improving treatment efficiency, work flow, and communication among interdisciplinary providers from different treatment settings.
Trial Registration: NCT02906215
Literature
1.
Results from the 2010 National Survey on Drug Use and Health: Summary of National Findings. In. Edited by Administration SAaMHS. Rockville, MD; 2011.
2.
Reece R, Dugdale C, Touzard-Romo F, Noska A, Flanigan T, Rich JD. Care at the crossroads: navigating the HIV, HCV, and substance abuse syndemic. Fed Pract Health Care Prof VA Dod PHS. 2014;31:37S–40S.
3.
Weber E, Morgan EE, Iudicello JE, Blackstone K, Grant I, Ellis RJ, Letendre SL, Little S, Morris S, Smith DM, et al. Substance use is a risk factor for neurocognitive deficits and neuropsychiatric distress in acute and early HIV infection. J Neurovirol. 2013;19(1):65–74.CrossRefPubMed
4.
Wang C, Vlahov D, Galai N, Cole SR, Bareta J, Pollini R, Mehta SH, Nelson KE, Galea S. The effect of HIV infection on overdose mortality. AIDS (London, England) 2005; 19(9):935–42.
5.
Chen IM, Huang CL-C, Yeh B-J, Chien Y-L. Health service utilization of heroin abusers: a retrospective cohort study. Addict Behav. 2015;45(281–286):286p.
6.
Onyeka IN, Beynon CM, Ronkainen K, Tiihonen J, Föhr J, Kuikanmäki O, Paasolainen M, Kauhanen J. Hospitalization in a cohort seeking treatment for illicit drug use in Finland. J Subst Abuse Treat. 2015;53:64–70.CrossRefPubMed
7.
Altice FL, Kamarulzaman A, Soriano VV, Schechter M, Friedland GH. Treatment of medical, psychiatric, and substance-use comorbidities in people infected with HIV who use drugs. The Lancet. 2010;376(9738):367–87.CrossRef
8.
Westergaard RP, Hess T, Astemborski J, Mehta SH, Kirk GD. Longitudinal changes in engagement in care and viral suppression for HIV-infected injection drug users. AIDS. 2013;27(16):2559–66.CrossRefPubMedPubMedCentral
9.
Rebeiro P, Althoff KN, Buchacz K, Gill J, Horberg M, Krentz H, Moore R, Sterling TR, Brooks JT, Gebo KA, et al. Retention among North American HIV-infected persons in clinical care, 2000–2008. J Acquir Immune Defic Syndr. 2013;62(3):356–62.CrossRefPubMedPubMedCentral
10.
Andersen R, Bozzette S, Shapiro M, St Clair P, Morton S, Crystal S, Goldman D, Wenger N, Gifford A, Leibowitz A, et al. Access of vulnerable groups to antiretroviral therapy among persons in care for HIV disease in the United States. HCSUS consortium. HIV cost and services utilization study. Health Serv Res. 2000;35(2):389–416.PubMedPubMedCentral
11.
Cunningham CO, Sohler NL, Cooperman NA, Berg KM, Litwin AH, Arnsten JH. Strategies to improve access to and utilization of health care services and adherence to antiretroviral therapy among HIV-infected drug users. Subst Use Misuse. 2011;46(2–3):218–32.CrossRefPubMedPubMedCentral
12.
Friedmann PD, Zhang Z, Hendrickson J, Stein MD, Gerstein DR. Effect of primary medical care on addiction and medical severity in substance abuse treatment programs. J Gen Intern Med. 2003;18(1):1–8.CrossRefPubMedPubMedCentral
13.
Disorders CoCtQCAtMHaA. Improving the quality of health care for mental and substance-use conditions: quality chasm series. Washington, DC: National Academies Press (US); 2006.
14.
Samet JH, Friedmann P, Saitz R. Benefits of linking primary medical care and substance abuse services: patient, provider, and societal perspectives. Arch Intern Med. 2001;161(1):85–91.CrossRefPubMed
15.
Drainoni M-L, Farrell C, Sorensen-Alawad A, Palmisano JN, Chaisson C, Walley AY. Patient perspectives of an integrated program of medical care and substance use treatment. AIDS Patient Care STDs. 2014;28(2):71–81.CrossRefPubMedPubMedCentral
16.
Kim TW, Saitz R, Cheng DM, Winter MR, Witas J, Samet JH. Effect of quality chronic disease management for alcohol and drug dependence on addiction outcomes. J Subst Abuse Treat. 2012;43(4):389–96.CrossRefPubMedPubMedCentral
17.
Urada D, Teruya C, Gelberg L, Rawson R. Integration of substance use disorder services with primary care: health center surveys and qualitative interviews. Subst Abuse Treat Prev Policy. 2014;9:15.CrossRefPubMedPubMedCentral
18.
Montague BT, Kahler CW, Colby SM, McHugh RK, Squires D, Fitzgerald B, Operario D, Gallagher D, Monti PM, Mayer KH. Attitudes and training needs of New England HIV care and addiction treatment providers: opportunities for better integration of HIV and alcohol treatment services. Addict Disord Their Treat. 2015;14(1):16–28.CrossRefPubMedPubMedCentral
19.
Sanchez K, Thompson S, Alexander L. Current strategies and barriers in integrated health care: a survey of publicly funded providers in Texas. Gen Hosp Psychiatr. 2010;32(1):26–32.CrossRef
20.
Rudin RS, Bates DW. Let the left hand know what the right is doing: a vision for care coordination and electronic health records. J Am Med Inf Assoc. 2014;21(1):13–6.CrossRef
21.
Bates DW. Health information technology and care coordination: the next big opportunity for informatics? Yearbook Med Inf. 2015;10(1):11–4.CrossRef
22.
Claborn KR, Manning D, Operario D, Ramsey S. Gaps in care coordination across the treatment cascade for HIV and addiction services. In: International symposium on HIV and emerging infectious diseases. Marseilles, 2016.
23.
Muessig KE, Pike EC, Legrand S, Hightow-Weidman LB. Mobile phone applications for the care and prevention of HIV and other sexually transmitted diseases: a review. J Med Internet Res. 2013;15(1):e1.CrossRefPubMedPubMedCentral
24.
Van Houdt S, Heyrman J, Vanhaecht K, Sermeus W, De Lepeleire J. An in-depth analysis of theoretical frameworks for the study of care coordination. Int J Integr Care. 2013;13:e024.PubMedPubMedCentral
25.
Van Houdt S, Sermeus W, Vanhaecht K, De Lepeleire J. Focus groups to explore healthcare professionals’ experiences of care coordination: towards a theoretical framework for the study of care coordination. BMC Fam Pract. 2014;15:177.CrossRefPubMedPubMedCentral
26.
Friedmann PD, Wilson D, Knudsen HK, Ducharme LJ, Welsh WN, Frisman L, Knight K, Lin H-J, James A, Albizu-Garcia CE, et al. Effect of an organizational linkage intervention on staff perceptions of medication-assisted treatment and referral intentions in community corrections. J Subst Abuse Treat. 2015;50:50–8.CrossRefPubMed
27.
Becker SJ, Squires DD, Strong DR, Barnett NP, Monti PM, Petry NM. Training opioid addiction treatment providers to adopt contingency management: a prospective pilot trial of a comprehensive implementation science approach. Subs. 2016;37(1):134–40. doi:10.​1080/​08897077.​2015.​1129524.
28.
Beidas RS, Kendall PC. Training therapists in evidence-based practice: a critical review of studies from a systems-contextual perspective. Clin Psychol Sci Pract. 2010;17(1):1–30.CrossRef
29.
Herschell AD, Kolko DJ, Baumann BL, Davis AC. The role of therapist training in the implementation of psychosocial treatments: a review and critique with recommendations. Clin Psychol Rev. 2010;30(4):448–66.CrossRefPubMedPubMedCentral
30.
Sholomskas DE, Syracuse-Siewert G, Rounsaville BJ, Ball SA, Nuro KF, Carroll KM. We don’t train in vain: a dissemination trial of three strategies of training clinicians in cognitive-behavioral therapy. J Consult Clin Psychol. 2005;73(1):106–15.CrossRefPubMedPubMedCentral
31.
Gale NK, Heath G, Cameron E, Rashid S, Redwood S. Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med Res Methodol. 2013;13:117.CrossRefPubMedPubMedCentral
32.
Heath G, Cameron E, Cummins C, Greenfield S, Pattison H, Kelly D, Redwood S. Paediatric ‘care closer to home’: stake-holder views and barriers to implementation. Health Place. 2012;18(5):1068–73.CrossRefPubMed
33.
Guest G, MacQueen KM, Namey E. Applied thematic analysis. Thousand Oaks, CA: Sage Publications, Inc.; 2012.CrossRef
34.
Squires DD, Gumbley SJ, Storti SA. Training substance abuse treatment organizations to adopt evidence-based practices: the Addiction Technology Transfer Center of New England Science to Service Laboratory. J Subst Abuse Treat. 2008;34(3):293–301.CrossRefPubMed
35.
Leon AC, Davis LL, Kraemer HC. The role and interpretation of pilot studies in clinical research. J Psychiatr Res. 2011;45(5):626–9.CrossRefPubMed
36.
Dugosh KL, Festinger DS, Marlowe DB, Clements NT. Developing an index to measure the voluntariness of consent to research. J Empir Res Human Res Ethics. 2014;9(4):60–70.CrossRef
37.
Dugosh KL, Festinger DS, Croft JR, Marlowe DB. Measuring coercion to participate in research within a doubly vulnerable population: Initial development of the Coercion Assessment Scale. J Empir Res Human Res Ethics. 2010;5(1):93–102.CrossRef
38.
Windsor LC, Benoit E, Ream GL, Forenza B. The provider perception inventory: Psychometrics of a scale designed to measure provider stigma about HIV, substance abuse, and MSM behavior. AIDS Care. 2013;25(5):586–91.CrossRefPubMed
39.
Frey BB, Lohmeier JH, Lee SW, Tollefson N. Measuring collaboration among grant partners. Am J Eval. 2006;27(3):383–92.CrossRef
40.
Townsend A, Shelley K. Validating an instrument for assessing workforce collaboration. Commun Coll J Res Pract. 2008;32(2):101–12.CrossRef
41.
Shea CM, Jacobs SR, Esserman DA, Bruce K, Weiner BJ. Organizational readiness for implementing change: a psychometric assessment of a new measure. Implement Sci. 2014;9:7.CrossRefPubMedPubMedCentral
42.
Ehrhart MG, Aarons GA, Farahnak LR. Assessing the organizational context for EBP implementation: the development and validity testing of the Implementation Climate Scale (ICS). Implement Sci. 2014;9:157.CrossRefPubMedPubMedCentral
43.
Kraemer HC, Mintz J, Noda A, Tinklenberg J, Yesavage JA. Caution regarding the use of pilot studies to guide power calculations for study proposals. Arch Gen Psychiatry. 2006;63(5):484–9.CrossRefPubMed
44.
Lix LM, Keselman HJ. Analysis of variance: repeated-measures designs. In: Hancock G, Mueller R, editors. The reviewer’s guide to quantitative methods in the social sciences. New York, NY: Routledge; 2010.
Metadata
Title
Mobile technology intervention to improve care coordination between HIV and substance use treatment providers: development, training, and evaluation protocol
Authors
Kasey Claborn
Sara Becker
Susan Ramsey
Josiah Rich
Peter D. Friedmann
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Addiction Science & Clinical Practice / Issue 1/2017
Electronic ISSN: 1940-0640
DOI
https://doi.org/10.1186/s13722-017-0073-1

Other articles of this Issue 1/2017

Addiction Science & Clinical Practice 1/2017 Go to the issue

Research

Alcohol consumption patterns and HIV viral suppression among persons receiving HIV care in Florida: an observational study

Study protocol

Technology-assisted intervention for parents of adolescents in residential substance use treatment: protocol of an open trial and pilot randomized trial

Research

Delivery of screening and brief intervention for unhealthy alcohol use in an urban academic Federally Qualified Health Center

Research

Enhancing patient navigation to improve intervention session attendance and viral load suppression of persons with HIV and substance use: a secondary post hoc analysis of the Project HOPE study

Research

HIV treatment cascade among female entertainment and sex workers in Cambodia: impact of amphetamine use and an HIV prevention program

Research

Validation of the AUDIT-C in adults seeking help with their drinking online