TY - JOUR KW - Adult KW - Alcoholism/rehabilitation KW - Cocaine-Related Disorders/rehabilitation KW - Continuity of Patient Care KW - Counseling KW - Female KW - Humans KW - Male KW - Patient Compliance KW - Recurrence/prevention & control KW - Self Efficacy KW - Self-Help Groups KW - Social Support KW - Telephone KW - Treatment Outcome AU - J. R. McKay AU - K. G. Lynch AU - D. S. Shepard AU - J. Morgenstern AU - R. F. Forman AU - H. M. Pettinati A1 - AB - AIMS: To determine whether substance use severity, psychiatric severity, social support, self-help attendance or motivation moderated substance use outcomes in a telephone-based continuing care intervention. DESIGN: A randomized study comparing three 12-week continuing care interventions: weekly telephone monitoring and counseling combined with a support group in the first 4 weeks (TEL), twice-weekly individualized relapse prevention (RP) and twice-weekly standard group counseling (STND). METHODS: Following completion of 4-week intensive out-patient programs (IOP), 359 patients with alcohol and/or cocaine dependence were assigned randomly to a continuing care condition and followed quarterly for 12 months. Ten potential moderator variables were examined in separate analyses. Two of these variables reflected pretreatment status, whereas the other variables were focused on performance while in the IOP. A composite risk measure was also constructed from dichotomized versions of seven of these variables, with higher scores indicating greater potential for relapse. The dependent measures were total abstinence and percentage of days abstinent from alcohol and cocaine in each quarter. FINDINGS: Of 40 interaction contrasts that were examined with individual risk indicator measures, only one reached the 0.05 level of significance. Patients with any alcohol use in IOP had a higher percentage of days abstinence in STND than in TEL. In addition, high scores on the composite risk indicator predicted higher total abstinence rates in STND than in TEL, whereas low to moderate scores predicted higher abstinence rates in TEL than in STND. CONCLUSION: For most graduates of IOPs, the combination of brief weekly telephone therapeutic contacts and a support group in the first month produced outcomes that are as good as those obtained in more intensive face-to-face continuing care interventions. However, patients with current dependence on both alcohol and cocaine who make little progress towards achieving the central goals of IOP may have better outcomes if they receive twice-weekly group counseling following IOP. BT - Addiction (Abingdon, England) C5 - HIT & Telehealth CP - 2 CY - England DO - 10.1111/j.1360-0443.2005.00972.x IS - 2 JF - Addiction (Abingdon, England) N2 - AIMS: To determine whether substance use severity, psychiatric severity, social support, self-help attendance or motivation moderated substance use outcomes in a telephone-based continuing care intervention. DESIGN: A randomized study comparing three 12-week continuing care interventions: weekly telephone monitoring and counseling combined with a support group in the first 4 weeks (TEL), twice-weekly individualized relapse prevention (RP) and twice-weekly standard group counseling (STND). METHODS: Following completion of 4-week intensive out-patient programs (IOP), 359 patients with alcohol and/or cocaine dependence were assigned randomly to a continuing care condition and followed quarterly for 12 months. Ten potential moderator variables were examined in separate analyses. Two of these variables reflected pretreatment status, whereas the other variables were focused on performance while in the IOP. A composite risk measure was also constructed from dichotomized versions of seven of these variables, with higher scores indicating greater potential for relapse. The dependent measures were total abstinence and percentage of days abstinent from alcohol and cocaine in each quarter. FINDINGS: Of 40 interaction contrasts that were examined with individual risk indicator measures, only one reached the 0.05 level of significance. Patients with any alcohol use in IOP had a higher percentage of days abstinence in STND than in TEL. In addition, high scores on the composite risk indicator predicted higher total abstinence rates in STND than in TEL, whereas low to moderate scores predicted higher abstinence rates in TEL than in STND. CONCLUSION: For most graduates of IOPs, the combination of brief weekly telephone therapeutic contacts and a support group in the first month produced outcomes that are as good as those obtained in more intensive face-to-face continuing care interventions. However, patients with current dependence on both alcohol and cocaine who make little progress towards achieving the central goals of IOP may have better outcomes if they receive twice-weekly group counseling following IOP. PP - England PY - 2005 SN - 0965-2140; 0965-2140 SP - 216 EP - 226 EP - T1 - Do patient characteristics and initial progress in treatment moderate the effectiveness of telephone-based continuing care for substance use disorders? T2 - Addiction (Abingdon, England) TI - Do patient characteristics and initial progress in treatment moderate the effectiveness of telephone-based continuing care for substance use disorders? U1 - HIT & Telehealth U3 - 10.1111/j.1360-0443.2005.00972.x VL - 100 VO - 0965-2140; 0965-2140 Y1 - 2005 ER -