Crandal Brent R, Eger William H, Hillery Naomi, Panczakiewicz Amy, Xu Zhun, Arriola Freddy, Dickson Kelsey S
Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.
Chadwick Center for Children & Families at Rady Children's Hospital, San Diego, CA, USA.
Drug Alcohol Depend Rep. 2025 Apr 11;15:100332. doi: 10.1016/j.dadr.2025.100332. eCollection 2025 Jun.
Substance use disorder (SUD) treatment effectiveness relies on service continuity during care transitions (e.g., residential to outpatient). Motivational Enhancement for Engagement in Treatment (MEET) is a structured engagement-focused intervention designed to improve service utilization. This study tests the real-world effectiveness of MEET for individuals transitioning between SUD treatment settings.
Individuals receiving withdrawal management and residential SUD treatment in the San Diego County Behavioral Health Services Drug Medi-Cal Organized Delivery System between March 2021-January 2022 were included in this study. We used logistic regression via generalized estimating equations to calculate adjusted odds ratios (AORs) and 95 % confidence intervals (CIs) that accounted for clustering within treatment facilities and individuals, and stabilized inverse probability of treatment weighting (IPTW) of baseline covariates to assess the probability of connecting to step-down SUD treatment given intervention status (MEET or treatment as usual). We also assessed the probability of timely connection to step-down treatment (i.e., within 10 days of discharge).
Of 10,011 participants in this quasi-experimental study, 141 (1.4 %) received MEET. Participants who received MEET were more likely to be connected to SUD treatment (AOR=1.79, 95 % CI: 1.11, 2.90) and of being connected in ≤ 10 days (AOR=1.65, 95 % CI: 1.01, 2.70) than participants who did not receive the intervention.
Among individuals with a SUD, MEET demonstrated real-world effectiveness for improving connections to step-down care, with participants receiving the intervention having nearly twice the odds of timely connection. This indicates practical engagement-based interventions can improve SUD treatment continuity across care transitions.
物质使用障碍（SUD）治疗的有效性依赖于护理过渡期间（如从住院治疗到门诊治疗）的服务连续性。治疗参与动机强化（MEET）是一种以参与为重点的结构化干预措施，旨在提高服务利用率。本研究测试了MEET对处于SUD治疗环境过渡阶段的个体在现实世界中的有效性。
本研究纳入了2021年3月至2022年1月期间在圣地亚哥县行为健康服务药物医疗救助有组织交付系统中接受戒断管理和住院SUD治疗的个体。我们通过广义估计方程使用逻辑回归来计算调整后的比值比（AOR）和95%置信区间（CI），该模型考虑了治疗机构和个体内部的聚类情况，并对基线协变量进行了稳定的逆概率治疗加权（IPTW），以评估根据干预状态（MEET或常规治疗）连接到降级SUD治疗的概率。我们还评估了及时连接到降级治疗的概率（即出院后10天内）。
在这项准实验研究的10,011名参与者中，141人（1.4%）接受了MEET。与未接受干预的参与者相比，接受MEET的参与者更有可能连接到SUD治疗（AOR = 1.79，95% CI：1.11，2.90），并且在≤10天内连接的可能性更大（AOR = 1.65，95% CI：1.01，2.70）。
在患有SUD的个体中，MEET在改善与降级护理的连接方面显示出在现实世界中的有效性，接受干预的参与者及时连接的几率几乎是未接受干预者的两倍。这表明基于实际参与的干预措施可以改善SUD治疗在护理过渡期间的连续性。
