Starting Treatment With Agonist Replacement Therapies Follow-up Study

• ClinicalTrials.gov Identifier: NCT01592461
• Recruitment Status: Completed
• First Posted: May 7, 2012
• Last Update Posted: August 8, 2016
• Sponsor: University of California, Los Angeles
• Collaborator: National Institute on Drug Abuse (NIDA)
• Information provided by (Responsible Party): Yih-Ing Hser, University of California, Los Angeles

Study Description

Brief Summary:

The purpose of the study is to conduct a follow-up of substance abuse patients (n=1,269) about 2 to 5 years since they were originally recruited from 8 substance abuse treatment clinics (located in 5 states) to participate in a prior clinical trial study called "START" (Starting Treatment with Agonist Replacement Therapies). The START Follow-up Study will be conducted over 5 years and will involve three follow-up interviews with START participants.

The specific aims of the START Follow-up Study are as follows.

1. To determine longer-term outcomes of Suboxone versus methadone treatment received in the START
2. To investigate patient and treatment factors associated with post-START treatment access, utilization, and outcomes among Suboxone and methadone patients
3. To explore other correlates of the long-term outcomes among START patients.

Condition or disease
Opioid Dependence

Detailed Description:

The primary outcome is the trajectory of opioid use since START entry, operationalized as number of days using opioids per month over the follow-up period since START enrollment. Other long-term outcomes of interest will include alcohol and other drug use, mental and physical health, quality of life, criminal justice status, HIV/HCV risk behaviors, and mortality. Treatment access and utilization factors of interest will include: predisposing personal factors, treatment experiences, and perceptions and attitudes toward treatment. Other correlates of interest will include cognitive functioning, mental health functioning, and social support.

2.2 Hypotheses There will be no differences in long-term outcomes of participants randomized to Suboxone treatment versus methadone treatment. To assess this outcome, trajectories of opioid use (operationalized as number of days using opioids per month over the follow-up period since START enrollment) will be analyzed. Other secondary long-term outcomes of interest will also be analyzed and will include alcohol and other drug use, mental and physical health, quality of life, criminal justice status, HIV/HCV risk behaviors, and mortality. Participants with greater access and utilization of treatment, fewer predisposing personal factors, greater social support, and more positive perceptions and attitudes toward treatment, will be more likely to be a member of the low or decreasing drug use trajectories.

2.3 Study Design This longitudinal, observational study will involve contacting the study participants from the original START study for future assessments. The study is expected to be completed in five years.

The follow-up study will consist of three interviews of the START study participants, beginning approximately 2 to 5 years after initial enrollment in the START study and will assess these participants over a 5-year period to provide long-term outcome data 7 to 10 years after START enrollment. This study information will be supplemented by (electronic) medical and other administrative records, as available. An intent-to-treat design will be adopted to include all 1,269 study participants enrolled in START.

Figure 1 presents a summary of the timeline for the conduct of project activities. There will be three participant interviews over the five years of the project. After receiving IRB approval for the conduct of the study, the START community treatment provider (CTP) or Node staff will contact their START participants, obtain participant consent to take part in the follow-up study, and conduct the initial assessment. This assessment will take place in the clinic if possible and by phone if the participant is not able to come in person.

By agreeing to take part in this study the participant will agree to:

1. Updating their locator information initially and throughout the duration of the study;
2. Sharing of clinic and survey data with the lead research team (UCLA);
3. Completing various assessments and providing urine and oral fluid/blood specimens for lab assessments;
4. Providing access to administrative records (e.g., medical records, criminal justice records);
5. Being contacted by the study staff for 2 more interviews in person or by phone (consented prior to each interview).

Local CTP or Node staff will conduct the Visit 1 interview in Years 1-2 of the START follow-up study. Enrollment for the Visit 1 interview will remain open for the life of the study to allow sites that are able to continue to seek participants for Visit 1 beyond Year 2 of the study to do so. The Lead Node staff will conduct the Visit 2 interview by telephone approximately 12 months after the completion of Visit 1. The Lead Node and/or CTP staff will conduct another participant interview approximately 12-18 months after Visit 2 is completed. If a study participant is found late in the study progress for Visit 1, the following visits, 2 and 3 will occur sooner than originally planned, but as far apart as possible. All assessments are completed by the end of Year 5 of the START follow-up study.

Study Design

• Study Type: Observational
• Actual Enrollment: 877 participants
• Observational Model: Cohort
• Time Perspective: Prospective
• Official Title: START Follow-up Study (NIDA CTN Protocol 0050)
• Study Start Date: September 2010
• Actual Primary Completion Date: August 2016
• Actual Study Completion Date: August 2016

Groups and Cohorts

Outcome Measures

Primary Outcome Measures :

1. Opioid use as determined by the Timeline Follow Back measure [ Time Frame: from 2006-2009 to 2011-2016 ]
   Opiate use over approximately ten years time period

Secondary Outcome Measures :

1. mortality [ Time Frame: from 2006-2009 to 2011-2016 ]
   Rate of mortality over approximately ten years time period

Eligibility Criteria

• Ages Eligible for Study: 18 Years and older (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No
• Sampling Method: Non-Probability Sample

Study Population

Participants will include the 1,269 study participants from the original START Study (CTN-0027) that was conducted from 2006 to 2010 at eight community treatment programs (CTPs).

Criteria

Inclusion Criteria:

• To be eligible to participate in the study, individuals must have participated in CTN-0027 START.

Contacts and Locations

Locations

United States, California

Matrix Institute on Addictions

Los Angeles, California, United States, 90016

Bi-Valley Medical Clinic, Inc.

Sacramento, California, United States, 95838

BAART Programs

San Francisco, California, United States, 94102

United States, Connecticut

Hartford Dispensary

Hartford, Connecticut, United States, 06120

Yale University School of Medicine

New Haven, Connecticut, United States, 06510

United States, Oregon

CODA, Inc.

Portland, Oregon, United States, 97214

United States, Pennsylvania

NET Steps

Philadelphia, Pennsylvania, United States, 19137

United States, Washington

Evergreen Treatment Services

Seattle, Washington, United States, 98134

Sponsors and Collaborators

University of California, Los Angeles

National Institute on Drug Abuse (NIDA)

Investigators

• Principal Investigator: Yih-Ing Hser, Ph.D.; University of California, Los Angeles

More Information

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Evans EA, Yoo C, Huang D, Saxon AJ, Hser YI. Effects of access barriers and medication acceptability on buprenorphine-naloxone treatment utilization over 2 years: Results from a multisite randomized trial of adults with opioid use disorder. J Subst Abuse Treat. 2019 Nov;106:19-28. doi: 10.1016/j.jsat.2019.08.002. Epub 2019 Aug 7.

• Responsible Party: Yih-Ing Hser, Professor, University of California, Los Angeles
• ClinicalTrials.gov Identifier: NCT01592461
• Other Study ID Numbers: CTN-0050; U10DA013045 ( U.S. NIH Grant/Contract )
• First Posted: May 7, 2012
• Last Update Posted: August 8, 2016
• Last Verified: August 2016

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: Yes
• Plan Description: Deidentified data will be shared via NIDA Clinical Trials Network Website

Keywords provided by Yih-Ing Hser, University of California, Los Angeles:

Substance abuse treatment outcomes; Opioid dependence; Suboxone; Methadone

Additional relevant MeSH terms:

Opioid-Related Disorders; Substance-Related Disorders; Chemically-Induced Disorders; Mental Disorders