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Completed

NCT Number: NCT03623178

Assertive Community Treatment for Patients Suffering From Substance Use Disorders

According to the World Health Organization the population suffering from addiction problems is increasing. This population is characterized by multiple needs at the medico-psychosocial level. However, some of these patients, a particular subgroup that we are going to be interested in the so-called "high need" user group, find it difficult to access and stay in outpatient treatment programs. Persons with substance use disorder often present a chaotic use of the health system, including a high number of hospitalizations in times of crisis. These individuals also show very low utilization of health care services, accompanied by social marginalization. This can be related to relapses and poor social functioning. A high number of relapses occur particularly at the end of hospitalization. Community Interventions, such as Assertive Community Treatment (ACT) should increase the adherence of these patients to treatment by accompanying them in the community and helping them during sensitive and crisis periods. One of the objectives of the study is to evaluate the impact of ACT on the time until service disengagement, measuring treatment adherence. The secondary objectives of this study will be to see the effect of ACT on duration and type of hospitalizations, as well as the number of emergency room visits. The investigators will focus on the impact of ACT on the participant's medico-psycho-social network, substance use and other psychological variables. The investigators will also evaluate his or her psychiatric symptoms and global and social functioning. Life satisfaction and satisfaction with the care received will also be measured. The study will investigate this through questionnaires at the beginning of care, at three months, six months and 12 months after the start of the ACT intervention.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

Service d'addictologie, HUG

Geneva, 1202, Switzerland

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Substance use disorder
  • Competent subjects, able to give informed consent
  • French speaking

Exclusion criteria

  • Evidence of organic brain disease or learning disability based on the chart review.

Treatment and study plan

Assertive Community Treatment

Other

The intervention program is a type of very flexible community treatment. This is facilitated by a small case load ratio per health care professional (1:10). The healthcare workers are specialized in SUD treatment. The time of the intervention differs, there is no prefixed limitation but the duration of the intervention depends on the goals agreed on with the patient. The main objective of this intervention is to ensure an adherence to an addiction treatment program and establish or consolidate a stable healthcare and social network for the patient. The intervention aims to prevent service disengagement. The healthcare workers will explore specific patient needs and ensure that health and social services are better coordinated to fit their needs.

Primary outcomes

  1. Treatment adherence

    Time frame: at 12 months

    Number of days until service disengagement

Secondary outcomes

  1. Service use

    Time frame: at 12 months

    Number of hospital admissions and number of days in hospital

  2. Patient network

    Time frame: 0, 3, 6, 12 months

    Number of persons in network

  3. Number of ER visits

    Time frame: 0, 3, 6, 12 months

    Number of ER visits reviewed on patient file

  4. Addictive behaviour

    Time frame: 0, 3, 6, 12 months

    Alcohol, Smoking and Substance Involvement Screening Test (ASSIST. V.3 French)

  5. General psychiatric symptoms

    Time frame: 0, 3, 6, 12 months

    Health of Nation Outcome Scale - French version (HoNOS-F): scores 0 - 52 (higher score = more psychiatric symptoms)

  6. Global Functioning

    Time frame: 0, 3, 6, 12 months

    World Health Organization Disability Assessment Schedule (WHODAS)

  7. General life satisfaction: Satisfaction With Life Scale

    Time frame: 0, 3, 6, 12 months

    Satisfaction With Life Scale: scores 5 - 35 (higher score = higher life satisfaction)

Other outcomes

  1. Patient satisfaction with Assertive Community Treatment

    Time frame: at 3, 6, 12 months

    Patient satisfaction with Assertive Community Treatment (very satisfied, satisfied, more or less satisfied, not satisfied

Sponsors and collaborators

Lead sponsor

University Hospital, Geneva

Other

Registry information

Official study title

Assertive Community Treatment for Patients Suffering From Substance Use

Important dates

Study start
2017
Primary completion
2023
Study completion
2023
First posted
Aug 9, 2018
Registry last updated
May 21, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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