Implementation of a Patient-Provider Agreement to Improve Healthcare Delivery for Patients With Substance Use Disorder in the Inpatient Setting

BACKGROUND Body motion-activated video games are a promising strategy for promoting engagement in and adherence to addiction treatment among youth. OBJECTIVE This pilot randomized trial (N=80) investigated the feasibility of a body motion–activated video game prototype, Recovery Warrior 2.0, targeting relapse prevention in the context of a community inpatient care program for youth. METHODS Participants aged 15-25 years were recruited from an inpatient drug treatment program and randomized to receive treatment as usual (control) or game play with treatment as usual (intervention). Assessments were conducted at baseline, prior to discharge, and at 4 and 8 weeks postdischarge. RESULTS The provision of the game play intervention was found to be feasible in the inpatient setting. On an average, participants in the intervention group played for 36.6 minutes and on 3.6 different days. Participants in the intervention group mostly agreed that they would use the refusal skills taught by the game. Participants in the intervention group reported attending more outpatient counseling sessions than those in the control group (10.8 versus 4.8), but the difference was not significant (P=.32). The game had no effect on drug use at 4 or 8 weeks postdischarge, with the exception of a benefit reported at the 4-week follow-up among participants receiving treatment for marijuana addiction (P=.04). CONCLUSIONS Preliminary evidence indicates that a motion-activated video game for addiction recovery appears to be feasible and acceptable for youth within the context of inpatient treatment, but not outpatient treatment. With further development, such games hold promise as a tool for the treatment of youth substance use disorder. CLINICALTRIAL ClinicalTrials.gov NCT03957798; https://clinicaltrials.gov/show/NCT03957798 (Archived by WebCite at http://www.webcitation.org/78XU6ENB4)

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A missed opportunity: underutilization of inpatient behavioral health services to reduce injection drug use sequelae in Florida

Substance Abuse Treatment Prevention and Policy ◽

10.1186/s13011-021-00383-w ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Austin E. Coye ◽

Mackenzie T. Jones ◽

Kasha J. Bornstein ◽

Hansel E. Tookes ◽

Joan E. St. Onge

Keyword(s):

Substance Use ◽

Health Services ◽

Behavioral Health ◽

Substance Use Disorder ◽

Hospital Admissions ◽

Inpatient Setting ◽

High Morbidity ◽

Coding System ◽

Behavioral Health Services ◽

Icd 10

Abstract Background People who inject drugs (PWID) suffer high morbidity and mortality from injection related infections (IRI). The inpatient setting is an ideal opportunity to treat underlying substance use disorder (SUD), but it is unclear how often this occurs. Objectives To quantify the utilization of behavioral health services for PWID during inpatient admissions for IRI. Methods Data for all hospital admissions in Florida in FY2017 were obtained from the Agency for Healthcare Administration. Hospitalization for IRI were obtained using a validated ICD-10 algorithm and treatment for substance use disorder was quantified using ICD-10-Procedure Coding System (ICD-10-PCS) codes. Result Among the 20,001 IRI admissions, there were 230 patients who received behavioral health services as defined by ICD-10-PCS SAT codes for treatment for SUD. Conclusions In a state with a large number of IRI, only a very small portion of admissions received behavioral health services. Increased efforts should be directed to studying referral patterns among physicians and other providers caring for this population and increasing utilization of behavioral health services.

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The Impact of an Inpatient Treatment on the Psychodynamic and Symptomatology in Couples Concordant for Substance Use: A Qualitative Study

10.21203/rs.2.19604/v1 ◽

2020 ◽

Author(s):

Aksel Hansen ◽

Stefan Brokatzky ◽

Kai Thomas ◽

Christina Sternbauer ◽

Myriam Rudaz ◽

...

Keyword(s):

Substance Use ◽

Substance Use Disorder ◽

Couples Therapy ◽

Inpatient Treatment ◽

Brief Symptom Inventory ◽

Inpatient Setting ◽

Drug Rehabilitation ◽

Psychosocial Situation ◽

The Impact

Abstract Background: Much literature is devoted to describing the psychosocial situation of patients with a substance use disorder and the course of their families and healthy partners. Couples where both partners have a substance use disorder are less well described and even less often studied. Method: This study described the psychodynamic and symptomatology, as measured by the Brief Symptom Inventory (BSI), of five concordant couples treated simultaneously as inpatients at the same specialized substance use disorder ward. Results: The psychodynamic characterization of the couples revealed that the female was often the organizer, whereas the male was either the motivator or the lackey. In addition, the female was often emotionally dependent on the male. Most individuals showed symptom reductions from pre- to post-treatment, although the men seemed to benefit to a greater extent than the women. Moreover, the patients did not necessarily desire couples therapy. Conclusion: Treating couples concordant for substance use together in the same inpatient setting is unusual, but possible. The dynamics of couples in drug rehabilitation should be further investigated taking into account possible gender differences.

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A Missed Opportunity: Underutilization of Inpatient Behavioral Health Services to Reduce Injection Drug Use Sequelae in Florida

10.21203/rs.3.rs-201907/v1 ◽

2021 ◽

Author(s):

Austin Coye ◽

Mackenzie T Jones ◽

Kasha J. Bornstein ◽

Hansel E. Tookes ◽

Joan E. St. Onge

Keyword(s):

Substance Use ◽

Health Services ◽

Behavioral Health ◽

Substance Use Disorder ◽

Hospital Admissions ◽

Inpatient Setting ◽

High Morbidity ◽

Coding System ◽

Behavioral Health Services ◽

Icd 10

Abstract Background: People who inject drugs (PWID) suffer high morbidity and mortality from injection related infections (IRI). The inpatient setting is an ideal opportunity to treat underlying substance use disorder (SUD), but it is unclear how often this occurs.Objectives: To quantify the utilization of behavioral health services for PWID during inpatient admissions for IRI.Design: Data for all hospital admissions in Florida in FY2017 were obtained from the Agency for Healthcare Administration.Subjects: Hospitalization for IRI were obtained using a validated ICD-10 algorithm and treatment for substance use disorder was quantified using ICD-10-Procedure Coding System (ICD-10-PCS) codes.Main Measure: Behavior health services associated with IRI admissionsKey Results: Among the 20,001 IRI admissions, there were 230 patients who received behavioral health services as defined by ICD-10-PCS SAT codes for treatment for SUD.Conclusions: In a state with a large number of IRI, only a very small portion of admissions received behavioral health services. Increased efforts should be directed to studying referral patterns among physicians and other providers caring for this population and increasing utilization of behavioral health services.

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