Retention and Re-Engagement in Treatment for Addiction Following Serious Injection Related Infections (RETAIN)

Purpose

This project is a pilot study of an adapted intervention of an existing Opioid Use Disorder (OUD) treatment retention intervention called Recovery Management Checkups (RMC). This intervention has been adapted to better fit the experiences and unique issues of those that have been hospitalized with serious injection related infections (SIRI) based on the findings from a prior qualitative study from the principal investigator. This project plans to test the adapted intervention within a smaller group of participants to assess feasibility, acceptability, and calculate early findings of intervention efficacy. Hospitalizations for SIRIs are a unique entry point for patients to start their recovery journey with medications for OUD (MOUD), but many people do not remain on long-term treatment, despite evidence that indicates MOUDs reduce death and re-hospitalization after SIRIs. The study objectives are to: - Assess the implementation feasibility of the adapted RMC model for patients with SIRI and OUD. - Establish preliminary estimates of intervention efficacy. - Make further adaptions to the intervention that will reduce both known and unknown barriers to care and increase effectiveness in future larger scale trials. Findings from this pilot study will result in further intervention refinement to better fit the target population, and serve as the basis for a larger randomized control trial that will have aims focused on more in-depth analysis of the efficacy of this program

Conditions

  • Opioid Use Disorder
  • Bloodstream Infection
  • Osteomyelitis
  • Endocarditis
  • Septic Arthritis
  • Epidural Abscess

Eligibility

Eligible Ages
Between 18 Years and 65 Years
Eligible Genders
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • Between 18 and 65 years of age - Able to provide Informed Consent - Admitted to Boston Medical Center on any inpatient unit for an active serious injection related infection (SIRI) such as endocarditis, osteomyelitis, bacteremia, septic arthritis, epidural abscess or other serious infection in which two weeks or more of antibiotics are recommended

Exclusion Criteria

  • Not able to give informed consent - Cognitive ability (defined through Research Assistant (RA) determination) - Inability to complete assessments in English or Spanish (defined through RA determination). - Exclusion for any reason under PI discretion - Unable to provide names and contact information for at least two verifiable locator persons who will know where to find them in the future. - In police custody or expecting incarceration

Study Design

Phase
N/A
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Intervention Model Description
The randomization process will involve assigning participants to either the intervention or control group The Randomization ratio will be 2:1 to intervention and will be done after enrollment by a research assistant through an automated Redcap feature.
Primary Purpose
Treatment
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
RETAIN intervention
Participants randomized to the RETAIN intervention will receive Motivational Interviewing targeted to their clinical concerns and personalized support tailored to each participants' specific needs determined by their answers to intake questions.
  • Other: RETAIN
    There are 6 different modules that a participant in the RETAIN intervention group can be placed in: "Reinforce Antibiotic Completion", "Linkage to Antibiotic Treatment/Alternate Plan", "Reinforce Recovery", "Linkage to MOUD/Alternate Plan", "Reinforce Treatment Attendance", and "Harm Reduction Support". Participants may be assigned to no more than three modules at a time until they finish their antibiotics. After the completion of antibiotics, participants may only be in two modules. Participants' intervention can range from 15 minutes- 60 minutes depending on what modules they are placed in and how much support they feel they need. Interventions will begin at the two-week follow up after a participant has been discharged from Boston Medical Center (BMC).
Active Comparator
Control
Control arm participants will be offered different videos or podcast episodes that are unrelated to the study topics of infections, substance use, overdose, and medication management.
  • Other: Unrelated videos
    These videos unrelated to the study topics will last approximately 30-45 minutes. Depending on the method of communication, participants will watch a video (in person) or listen to a podcast (remote)

Recruiting Locations

Boston Medical Center
Boston, Massachusetts 02118
Contact:
Simeon Kimmel, MD
857-292-6484
Simeon.Kimmel@bmc.org

More Details

Status
Recruiting
Sponsor
Boston Medical Center

Study Contact

Simeon Kimmel, MD
617-414-6927
Simeon.Kimmel@bmc.org