Chronic Care Management No Benefit in Drug Dependence (En)

Chronic care management (CCM) is no better than usual primary care for self-reported abstinence for those with alcohol or drug dependence, according to a study published in the Sept. 18 issue of the Journal of the American Medical Association.

Richard Saitz, MD, MPH, from the Boston Medical Center, and colleagues conducted a randomized study involving 563 individuals with alcohol and other drug dependence to compare CCM (282 participants) with usual primary care (281 participants) for substance use outcomes. CCM included primary care clinician-coordinated longitudinal care; motivational enhancement therapy; counseling to prevent relapse; on-site medical, addiction, and psychiatric treatment; assistance from social workers; and appropriate referrals. The control group received a primary care appointment and list of treatment resources.

The researchers found that there was no significant difference in abstinence from opioids, stimulants, or heavy drinking between the groups (44% for CCM group vs. 42% for control group). Secondary outcomes, including addiction severity, health-related quality of life, or drug problems, did not differ significantly between the groups. CCM correlated with fewer alcohol problems in those with alcohol dependence (mean score, 10 vs. 13; P=0.048).

“In this trial of persons with alcohol and other drug dependence, CCM, compared with a primary care appointment but no CCM, did not decrease use or overall addiction consequences,” the authors write.

One author disclosed financial ties to Johnson & Johnson and Janssen.

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