Baseline medical comorbidities in adults randomized in the STRIDE trial for psychostimulant use disorders

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Abstract

Background and Objectives: Rates of medical illnesses may be higher among individuals with substance use disorders, complicating their care. This study aimed to expand the understanding of other medical conditions in treatment-seeking adults with stimulant use disorder (SUD) using data from Stimulant Reduction Intervention using Dose Exercise (STRIDE), a randomized, multisite trial investigating exercise augmentation of treatment as usual. Methods: Utilizing STRIDE baseline data, we examined demographic and clinical characteristics based on the number of self-reported diagnosed medical conditions among participants meeting eligibility criteria (passing medical screening exam and maximal exercise test, non-opioid dependent, no concomitant beta blocker, or opioid replacement therapy). Results: The majority (59%) of study participants (N=302, mean age all participants=39 years) did not report any history of other medical problems. Those with two or more conditions were older (mean age 46 years), reported more pain and worse physical functioning, and more psychiatric disorders (average 1.44). Hypertension was more common among participants with cocaine use disorders only (present in 16%) and liver disease was more common in those with cocaine plus other stimulant use disorders (present in 7%). Conclusion and Scientific Significance: In this sample, patients with SUD were in surprisingly good health. A subpopulation had an overall higher burden of illness with worsened physical and psychiatric functioning. Provision of coordinated care may optimize treatment outcomes for patients based on medical comorbidity burden as well as type of drug abused, although these conclusions should be considered preliminary as they are based on self-reported data.

Original languageEnglish (US)
JournalAmerican Journal on Addictions
DOIs
StateAccepted/In press - 2016

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Comorbidity
Exercise
Cocaine
Psychiatry
Opiate Substitution Treatment
Cost of Illness
Exercise Test
Substance-Related Disorders
Liver Diseases
Demography
Hypertension
Pain
Health
Therapeutics
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

@article{dbd0147af00a4758b432a29cea29fb03,
title = "Baseline medical comorbidities in adults randomized in the STRIDE trial for psychostimulant use disorders",
abstract = "Background and Objectives: Rates of medical illnesses may be higher among individuals with substance use disorders, complicating their care. This study aimed to expand the understanding of other medical conditions in treatment-seeking adults with stimulant use disorder (SUD) using data from Stimulant Reduction Intervention using Dose Exercise (STRIDE), a randomized, multisite trial investigating exercise augmentation of treatment as usual. Methods: Utilizing STRIDE baseline data, we examined demographic and clinical characteristics based on the number of self-reported diagnosed medical conditions among participants meeting eligibility criteria (passing medical screening exam and maximal exercise test, non-opioid dependent, no concomitant beta blocker, or opioid replacement therapy). Results: The majority (59{\%}) of study participants (N=302, mean age all participants=39 years) did not report any history of other medical problems. Those with two or more conditions were older (mean age 46 years), reported more pain and worse physical functioning, and more psychiatric disorders (average 1.44). Hypertension was more common among participants with cocaine use disorders only (present in 16{\%}) and liver disease was more common in those with cocaine plus other stimulant use disorders (present in 7{\%}). Conclusion and Scientific Significance: In this sample, patients with SUD were in surprisingly good health. A subpopulation had an overall higher burden of illness with worsened physical and psychiatric functioning. Provision of coordinated care may optimize treatment outcomes for patients based on medical comorbidity burden as well as type of drug abused, although these conclusions should be considered preliminary as they are based on self-reported data.",
author = "{dela Cruz}, {Adriane M.} and Thomas Carmody and Greer, {Tracy L.} and Rethorst, {Chad D.} and Diane Warden and Robrina Walker and Trivedi, {Madhukar H.}",
year = "2016",
doi = "10.1111/ajad.12363",
language = "English (US)",
journal = "American Journal on Addictions",
issn = "1055-0496",
publisher = "Wiley-Blackwell",

}

TY - JOUR

T1 - Baseline medical comorbidities in adults randomized in the STRIDE trial for psychostimulant use disorders

AU - dela Cruz, Adriane M.

AU - Carmody, Thomas

AU - Greer, Tracy L.

AU - Rethorst, Chad D.

AU - Warden, Diane

AU - Walker, Robrina

AU - Trivedi, Madhukar H.

PY - 2016

Y1 - 2016

N2 - Background and Objectives: Rates of medical illnesses may be higher among individuals with substance use disorders, complicating their care. This study aimed to expand the understanding of other medical conditions in treatment-seeking adults with stimulant use disorder (SUD) using data from Stimulant Reduction Intervention using Dose Exercise (STRIDE), a randomized, multisite trial investigating exercise augmentation of treatment as usual. Methods: Utilizing STRIDE baseline data, we examined demographic and clinical characteristics based on the number of self-reported diagnosed medical conditions among participants meeting eligibility criteria (passing medical screening exam and maximal exercise test, non-opioid dependent, no concomitant beta blocker, or opioid replacement therapy). Results: The majority (59%) of study participants (N=302, mean age all participants=39 years) did not report any history of other medical problems. Those with two or more conditions were older (mean age 46 years), reported more pain and worse physical functioning, and more psychiatric disorders (average 1.44). Hypertension was more common among participants with cocaine use disorders only (present in 16%) and liver disease was more common in those with cocaine plus other stimulant use disorders (present in 7%). Conclusion and Scientific Significance: In this sample, patients with SUD were in surprisingly good health. A subpopulation had an overall higher burden of illness with worsened physical and psychiatric functioning. Provision of coordinated care may optimize treatment outcomes for patients based on medical comorbidity burden as well as type of drug abused, although these conclusions should be considered preliminary as they are based on self-reported data.

AB - Background and Objectives: Rates of medical illnesses may be higher among individuals with substance use disorders, complicating their care. This study aimed to expand the understanding of other medical conditions in treatment-seeking adults with stimulant use disorder (SUD) using data from Stimulant Reduction Intervention using Dose Exercise (STRIDE), a randomized, multisite trial investigating exercise augmentation of treatment as usual. Methods: Utilizing STRIDE baseline data, we examined demographic and clinical characteristics based on the number of self-reported diagnosed medical conditions among participants meeting eligibility criteria (passing medical screening exam and maximal exercise test, non-opioid dependent, no concomitant beta blocker, or opioid replacement therapy). Results: The majority (59%) of study participants (N=302, mean age all participants=39 years) did not report any history of other medical problems. Those with two or more conditions were older (mean age 46 years), reported more pain and worse physical functioning, and more psychiatric disorders (average 1.44). Hypertension was more common among participants with cocaine use disorders only (present in 16%) and liver disease was more common in those with cocaine plus other stimulant use disorders (present in 7%). Conclusion and Scientific Significance: In this sample, patients with SUD were in surprisingly good health. A subpopulation had an overall higher burden of illness with worsened physical and psychiatric functioning. Provision of coordinated care may optimize treatment outcomes for patients based on medical comorbidity burden as well as type of drug abused, although these conclusions should be considered preliminary as they are based on self-reported data.

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