Continuity of Care Improves Abstinence among Veterans with Substance Use Disorder
Abstinence is a fundamental marker of success in substance use disorder (SUD) treatment programs, but 40% to 60% of patients return to active alcohol and drug use in the year after treatment. This study tested models of abstinence that included a comprehensive set of patient and treatment factors spanning the continuum of care. Investigators assessed data from 18 VA outpatient SUD programs treating 429 veterans with alcohol and/or drug problems; 82% had both an alcohol and drug disorder, and 32% were diagnosed with a co-existing psychiatric disorder. Data also included information on: patients’ motivations, treatment intensity and completion, and continuity of care practices, as well as abstinence rates.
Findings show that the use of outpatient mental health services in the year prior to treatment and the staff’s continuity of care practices were the most important factors for increasing abstinence rates, while engagement in continuing care was a key post-treatment factor. For example, veterans who had one or more SUD or psychiatric clinic visits in the year before intensive treatment had twice the odds of abstinence compared with veterans who had not used such services. Veterans also were more likely to be abstinent when staff provided continuing care appointments prior to discharge, developed discharge plans that called for patients to attend continuing care at least once a week, and arranged drug-free and sober living arrangements.
Schaefer J, Harris A, Cronkite R, and Turrubiartes P. Treatment staff’s continuity of care practices, patients’ engagement in continuing care, and abstinence following outpatient substance use disorder treatment. Journal of Studies on Alcohol and Drugs September 2008;69(5):747-56.
This study was funded through VA/HSR&D’s Substance Use Disorders Quality Enhancement Research Initiative (SUD-QUERI). All authors are part of HSR&D’s Center for Health Care Evaluation in Palo Alto, CA.
