Technologically-Augmented Referrals to Mitigate Addiction Consequences

Study Summary

The implementation of screening and intervention for substance use disorders, such as Screening Brief Intervention Referral to Treatment (SBIRT), in the primary care setting has faced several challenges. In the past, physicians have cited barriers such as lack of time, lack of access to treatment, and lack of financial resources. To overcome some of the barriers to screening and prevention of substance use disorders, many researchers have begun to explore novel approaches using web-based and mobile technology. While the quality of evidence is often inconsistent, there is promising research to show that interventions utilizing web-based or mobile technology for alcohol and other substance abuse can be effective. Features such as tailored feedback have shown to be more effective than similar programs without feedback, and interventions that combine self-administered therapy in conjunction with therapist-direction interventions show greater reductions in addictive behavior. In this project, the investigators proposed to enhance the Screening Brief Intervention Referral to Treatment (SBIRT) with a digital tool that aims to save physician time and improve patient adherence to treatment goals, through extensive use of shared decision making, patient self-monitoring and goal tracking, and real-time tailored patient feedback and text follow-up for patients. Increase the screening and referral of those patients at risk for substance use disorder (SUD) thereby increasing the number of patients receiving higher level substance use treatment. A total of 500 patients will be screened and randomized into two groups. 250 in the Technology Augmented Treatment group (intervention group) and 250 in the control group. The Washington State University research team, lead by Dr. McPherson, will screen and recruit subjects at CHAS Valley Clinic in Spokane, WA. Subjects in both groups will be followed up for 30 days. At the initial study enrollment visit, the intervention group will be

Primary Outcome

The investigators estimate that SBIRT intervention (Glass et al 2015) could result in 10% to 30% of patients receiving specialty care. The investigators computed power using the following assumptions: * Control arm with 20% participants receiving specialty care. * Intervention arm with 35% participants receiving specialty care. * Same number of participants in control and intervention. A sample of 197 participants in each of arms will be sufficiently powered to detect such differences between

Interventions

• BEHAVIORAL Technology Augmented Treatment for Screening, Brief Intervention, Referral, and Treatment (SBIRT)