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Do Patient Engagement Programs Improve Addiction Treatment?

Intervention programs tend to boost patient engagement in addiction treatment patients, ideally encouraging abstinence in the long-run.

By Sara Heath

Interactive patient engagement programs focused on overall health education show promise for helping patients manage their addiction treatment, research from Kaiser Permanente Northern California shows.

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The study, published this month in JAMA Psychiatry, investigates the effects of patient engagement and intervention strategies amongst patients dealing with alcohol and other drug (AOD) addiction.

The research team, led by Kaiser Permanente’s chief of Behavioral Health and Aging Constance M. Weisner, DrPH, separated AOD patients into two cohorts: those to receive regular care and those to receive patient engagement intervention care, both at a large outpatient addiction rehabilitation facility.

Those receiving the intervention care participated in LINKAGE, which uses EHRs and patient portals to engage patients in their own health, encouraging them to communicate with their providers, engage in preventative care, and better understand their treatment plans.

Ultimately, Weisner and colleagues found that those participating in LINKAGE had higher levels of patient satisfaction. By teaching patients critical engagement strategies, the program facilitates better communication between patients and providers and patient portal usage.

“The LINKAGE intervention taught skills to help patients communicate effectively with physicians and engage in their health care using the EHR as a platform,” the research team reported. “LINKAGE participants had more days of patient portal log-in, including seeking medical advice, receiving messages from primary care physicians, checking on laboratory test results, and reviewing medical information.”

Although LINKAGE boosted patient engagement levels for AOD patients, it did not make a significance in their health status. The results showed that patients in either cohort had equal levels of abstinence and depression following the six-month research period.

The researchers note that this study’s central focus was on patient engagement levels as a result of the LINKAGE program.  Investigations into abstinence and depression levels were secondary.

However, the team still posits an explanation for the results with regard to AOD abstinence and depression levels.

“Six months may not have been long enough to observe any differences in these outcomes given the intensive treatment program,” Weisner and colleagues explained.

“However, by taking better care of their health, we expect that LINKAGE participants will have better outcomes than [usual care] participants over time,” they continued. “Because AOD disorders are chronic health conditions requiring ongoing care, we also expect that, by engaging patients in their health care, potential service needs will be identified earlier and relapse avoided.”

Regardless, the research team’s findings that intervention programs like LINKAGE help boost patient engagement are noteworthy. Patients with AOD addiction often have several additional health issues. Between psychiatric needs and medical comorbidities, AOD patients typically have complex health needs.

As a result, it is imperative they take part in managing their own health to ensure adherence to treatment plans and quality, coordinated care across all points of care.

"Patients with alcohol and other drug use disorders have high rates of medical and psychiatric conditions requiring complex treatment, but often rely on emergency services and seldom use preventive services, even when they have health insurance," Weisner said in a press release.

"We know that patients who are more engaged with their health care tend to manage their condition better and our study found that alcohol and drug treatment patients are no different."

By implementing an intervention program like LINKAGE, patients can become educated in those engagement activities. In finding that LINKAGE works in boosting patient engagement, the researchers have identified a method by which they can improve AOD addiction patient health.

“This finding suggests a potential significant effect if the intervention was adopted as part of standard treatment,” the researchers explained. “Our findings suggest that patients receiving addiction treatment are interested in having a role in their health care and in using health information technology.”

Going forward, healthcare experts will need to focus on if and how improved patient engagement can improve AOD addiction patient abstinence to better implement strategies like LINKAGE.

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