Annually about 30,000 veterans receive inpatient detoxification (detox) for Substance Use Disorders (SUD). Detox does not actually treat SUDs, as the purpose for detox is initially to treat withdrawal to prevent complications which may be fatal.
The VA’s Mental Health Operations is working to eradicate the costly pattern of veterans obtaining inpatient detox services but not receiving the SUD treatment they need. So far, telehealth has not been used with the population of detox inpatient before but now the VA has established a multi-site randomized clinical trial that is examining telephone monitoring study at the VA Palo Alto Health Care System www.paloalto.va.gov.
The study titled “Telemonitoring to Improve SUD Treatment after Detox” with Christine Timko PhD as Principle Investigator, is going to implement and evaluate what the VA is calling “Enhanced Telephone Monitoring” (ETM). This new telehealth intervention can be used to help veterans transition from inpatient detox to SUD specialty treatment and at the same time, improve outcomes and reduce VA healthcare costs.
The randomized research trial taking place at the VA in Palo Alto and the VA in Boston, is using ETM to compare patients receiving the VA’s usual care with veterans that will be more likely to go into SUD treatment. The VA wants to find out if these veterans have better outcomes and fewer acute care episodes.
The patients in the ETM study will receive an in-person session while in detox, followed by coaching over the telephone for three month after discharge. The telephone call will incorporate motivational interviewing along with providing support while the veteran waits for treatment,
Patients are assessed at baseline and at three and six months post discharge for outcomes and non-VA healthcare. Databases will be used to assess the program using databases and analyses to compare usual care and ETM groups on the outcomes for veterans over time.
This project will also evaluate how to implement ETM throughout the VA while focusing on diverse subgroups of veterans. The project will conduct a budget impact analysis to determine the impact of ETM on total costs for the VA care. It has been predicted that the higher costs associated with ETM will be offset by the lower costs of acute care.
Go to www.hsrd.research.va.gov/research/abstracts.cfm?Project_ID=2141701898 for more details on the study.