TY - JOUR
T1 - Design of NIDA CTN protocol 0047
T2 - Screening, motivational assessment, referral, and treatment in emergency departments (SMART-ED)
AU - Bogenschutz, Michael P.
AU - Donovan, Dennis M.
AU - Adinoff, Bryon
AU - Crandall, Cameron
AU - Forcehimes, Alyssa A.
AU - Lindblad, Robert
AU - Mandler, Raul N.
AU - Oden, Neal L.
AU - Perl, Harold I.
AU - Walker, Robrina
PY - 2011/9
Y1 - 2011/9
N2 - Background: Medical settings such as emergency departments (EDs) present an opportunity to identify and provide services for individuals with substance use problems who might otherwise never receive any form of assessment, referral, or intervention. Although screening, brief intervention, and referral to treatment models have been extensively studied and are considered effective for individuals with alcohol problems presenting in EDs and other medical settings, the efficacy of such interventions has not been established for drug users presenting in EDs. Objectives: This article describes the design of a NIDA Clinical Trials Network protocol testing the efficacy of an screening, brief intervention, and referral to treatment model in medical EDs, highlighting considerations that are pertinent to the design of other studies targeting substance use behaviors in medical treatment settings. Methods: The protocol is described, and critical design decisions are discussed. Results: Design challenges included defining treatment conditions, study population, and site characteristics; developing the screening process; choosing the primary outcome; balancing brevity and comprehensiveness of assessment; and selecting the strategy for statistical analysis. Conclusion: Many of the issues arising in the design of this study will be relevant to future studies of interventions for addictions in medical settings. Scientific Significance: Optimal trial design is critical to determining how best to integrate substance abuse interventions into medical care.
AB - Background: Medical settings such as emergency departments (EDs) present an opportunity to identify and provide services for individuals with substance use problems who might otherwise never receive any form of assessment, referral, or intervention. Although screening, brief intervention, and referral to treatment models have been extensively studied and are considered effective for individuals with alcohol problems presenting in EDs and other medical settings, the efficacy of such interventions has not been established for drug users presenting in EDs. Objectives: This article describes the design of a NIDA Clinical Trials Network protocol testing the efficacy of an screening, brief intervention, and referral to treatment model in medical EDs, highlighting considerations that are pertinent to the design of other studies targeting substance use behaviors in medical treatment settings. Methods: The protocol is described, and critical design decisions are discussed. Results: Design challenges included defining treatment conditions, study population, and site characteristics; developing the screening process; choosing the primary outcome; balancing brevity and comprehensiveness of assessment; and selecting the strategy for statistical analysis. Conclusion: Many of the issues arising in the design of this study will be relevant to future studies of interventions for addictions in medical settings. Scientific Significance: Optimal trial design is critical to determining how best to integrate substance abuse interventions into medical care.
KW - Brief intervention
KW - Clinical trial
KW - Design
KW - Emergency department
KW - SBIRT
UR - http://www.scopus.com/inward/record.url?scp=80052224883&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=80052224883&partnerID=8YFLogxK
U2 - 10.3109/00952990.2011.596971
DO - 10.3109/00952990.2011.596971
M3 - Article
C2 - 21854285
AN - SCOPUS:80052224883
SN - 0095-2990
VL - 37
SP - 417
EP - 425
JO - American Journal of Drug and Alcohol Abuse
JF - American Journal of Drug and Alcohol Abuse
IS - 5
ER -