A Peer Recovery Coaching Intervention for Hospitalized Alcohol Use Disorder Patients
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Peer recovery coaching (PRC), Brief Intervention (SBIRT).
- Who it may be relevant to
- Registry conditions: Alcohol Use Disorder. Basic parameters: 18 years — 75 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- United States
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Overview
The project objective is to rigorously evaluate the effectiveness of a peer recovery coaching intervention (called RC-Link) in patients hospitalized with medical complications from alcohol use on recovery outcomes guided by the new NIAAA definition of recovery, examine mechanisms of heavy drinking using daily ecological momentary assessment (EMA), and determine the program's cost-effectiveness using an randomized controlled trial (RCT) design. The primary outcomes are frequency of heavy drinking, biopsychosocial functioning, and remission from AUD.
Detailed description
Alcohol Use Disorder (AUD) is the third leading cause of preventable deaths in U.S. and accounts for over 10% of U.S. hospital admissions. Treatment for this population often fails to address the underlying cause of the hospitalization: the AUD. Patients hospitalized with alcohol-related medical complications tend to have high-risk for recurrence of alcohol-related medical problems, high rates of hospital readmissions, and poor recovery outcomes. Methods that promote long-term recovery care are needed. Inpatient linkage to peer recovery coaching may bridge this gap in care by providing a method of continued care for AUD recovery that offers flexibility in recovery pathways, peer modeling opportunities, and strong social support. Pilot study results demonstrated the feasibility of inpatient linkage to peer recovery coaching and showed evidence of decreased alcohol consumption, increased engagement in treatment and recovery support programs, and decreased emergency department visits. However, pilot study sample size, outcomes, and methods were limited. This proposal seeks to overcome these limitations and build on these preliminary results by: using ecological momentary assessments, measuring recovery using the new NIAAA definition, examining cost-effectiveness, assessing alcohol consumption using an additional objective measure (breath alcohol content levels), and examining social support and self-efficacy as potential mechanisms of effectiveness. This proposal will rigorously test the effectiveness of an inpatient peer recovery coaching service called the RC-Link program on recovery outcomes in patients hospitalized with medical complications from AUD. The program involves a bedside introduction to a peer recovery coach during the patient's hospitalization plus continued, recovery support for six-months. The RC-Link program provides standardized peer recovery service that is both personalized to the patients' needs and generalized to provide socioemotional, instrumental, and informational social support during every patient encounter. Aim 1 will determine the effect of the RC-Link program on frequency of heavy drinking, biopsychosocial functioning, and remission from AUD compared to controls. Aim 2 will examine how daily changes in perceived social support and self-efficacy influence alcohol consumption and determine whether such associations differ between the RC-Link and control groups. Aim 3 will examine the cost-effectiveness of the RC-Link program; hospital utilization rates will be examined as secondary outcomes. These aims will be evaluated using a two-arm randomized controlled trial that compares the RC-Link program intervention to a control group that receives a brief intervention and connection to a peer recovery coach after the study period. Outcomes will be assessed at baseline, monthly during the 6-month study period, and 6-months post- intervention. This study has potential to advance recovery care for AUD by providing a better understanding of how long-term, inpatient-initiated peer recovery coaching influences recovery outcomes over time in this population.
Interventions
- Behavioral Peer recovery coaching (PRC)
The RC-Link peer recovery coaching intervention provides participants with an introduction to an RC-Link coach during their hospitalization. The RC-Link coach delivers coaching and support services for a 6-month period using a standardized PRC Checklist. During the baseline visit, the RC-Link coach first develops a personalized recovery plan with the participant that emphasizes multiple pathways to recovery, including different types of mutual aid groups, counseling, and alternative recovery too - Behavioral Brief Intervention (SBIRT)
The control will receive a brief intervention, usual care (a referral list), contact information for the study team and hospital case management, and a follow-up contact at the end of the study period. The brief intervention entails (a) using motivational interviewing to gauge the individual's perspective of drinking, how it influences their life, and readiness for change; (b) provide information about the risks of hazardous drinking and potential ways to reduce drinking; (c) elicit their feedba
Primary outcome measures
- Change in Percentage of Heavy Drinking Days Per Month [Time frame: one-month, 3-months, 6-months]
- Remission from Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) AUD Diagnosis [Time frame: one-month, 3-months, 6-months, 12-months]
- Change in Biopsychosocial Functioning [Time frame: one-month, 3-months, 6-months]
- Cost Effectiveness [Time frame: 6-months]
Secondary outcome measures (7)
- Change in Coping [Time frame: one-month, 3-months, 6-months, 12-months]
- Change in linkage to and engagement in Evidence-Based Practices [Time frame: one-month, 3-months, 6-months, 12-months]
- Change in linkage to and engagement in Social Determinants of Health (SDoH) resources [Time frame: one-month, 3-months, 6-months, 12-months]
- Hospital Utilization [Time frame: 6-months]
- EMA: Heavy Drinking [Time frame: 6-months]
- EMA: Breath Alcohol Content (BrAC) Levels [Time frame: 6-months]
- EMA: Change in Craving [Time frame: 6-months]
Eligibility criteria
Inclusion criteria
- Live within 50 miles of the recruitment and plan to stay in the area for at least 6 months
- Current DSM-V criteria for moderate or severe AUD (measured by a score of ≥4 on the DSM-V Checklist)
- Hospitalized with a principal, primary, or secondary AUD-related diagnosis
Exclusion criteria
- Unable to provide informed consent
- Patients referred to hospice during hospitalization
- Women who are pregnant
- Comorbid diagnosis or at-risk for methamphetamine, cocaine, or opioid use disorder as determined by a score of ≥4 on the National Institute on Drug Abuse (NIDA) Modified Assist v3.0
- Current suicidal ideation
- Incarcerated at time of hospitalization
- Currently has a peer recovery coach
- Toxicology screen positive for opiates, cocaine, or methamphetamine
- Experiencing moderate/severe alcohol withdrawal based on physician assessment
- Psychotic disorders or bipolar disorder documented in chart
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Single blind
- Primary purpose
- Treatment
Study locations
United States · 2 centers
- Greenville Memorial Hospital — Greenville
- Oconee Memorial Hospital — Seneca
Identifiers
NCT: NCT06479681 · 2089000(Prisma),2024-0110(CU) · 1R01AA030815