A Pragmatic Trial of the Consult for Addiction Treatment and Care in Hospitals (CATCH) Model for Engaging Patients in Opioid Use Disorder Treatment
Condition: Opioid Dependence; Opioid Abuse
MeSH terms: Opioid-Related Disorders
Study type: Observational [Patient Registry]

Summary: 
      This pragmatic clinical trial seeks to evaluate the effectiveness of the Consult for
      Addiction Treatment and Care in Hospitals (CATCH) intervention as a strategy for engaging
      patients with Opiod Use Disorder (OUD) in addiction treatment.
    

Detailed description: 
      The overarching objective of our study is to evaluate the effectiveness of CATCH as a
      strategy for engaging patients with OUD in MAT. A pragmatic trial at 6 hospitals, conducted
      in collaboration with the New York City Health and Hospitals system (H+H) and the New York
      City Department of Health and Mental Hygiene (DOHMH), will study the CATCH intervention in
      real-world settings and at scale. Guided by the RE-AIM evaluation framework, this hybrid
      effectiveness-implementation study (Type 1) focuses primarily on effectiveness, but also
      measures implementation outcomes to inform the intervention's adoption and sustainability. A
      rigorous stepped-wedge cluster randomized trial design determines the impact of CATCH on
      opioid treatment outcomes in comparison to usual care for a control period, followed by a
      12-month intervention period and a maintenance period, and utilizes existing administrative
      data to evaluate outcomes. Aim 1 (primary aim) is to evaluate the effectiveness of CATCH in
      increasing post-discharge initiation and engagement in MAT, defined respectively as receiving
      outpatient MAT within 14 days of discharge, and having at least 2 additional MAT visits in
      the first month. Aim 2 is to assess the effectiveness of CATCH for increasing treatment
      retention, defined as continuous receipt of MAT for 6 months. Aim 3 is to compare the
      frequency of acute care utilization and overdose deaths, and their associated costs, among
      patients with OUD who are hospitalized during the CATCH period versus usual care. Aim 4 is to
      evaluate implementation outcomes at CATCH sites using a mixed methods approach to assess the
      intervention's Reach (proportion of eligible patients reached); Adoption (utilization by
      medical staff); and Implementation fidelity (barriers to delivering high-quality MAT).
    

Intervention name(s): CATCH Interviews
Intervention type(s): Behavioral
Intervention description(s): Baseline interviews are conducted with CATCH staff (5/site); while Post-implementation interviews are conducted 9-12 months after introduction of CATCH, with CATCH staff (5/site) and patients (5/site)
Observational model: Other
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Our study retrospectively analyzes administrative data for patients with OUD who have been
        hospitalized at the participating sites. These patients are not recruited or enrolled.The
        cases identified through administrative data consists of individuals with OUD who are
        hospitalized at one of the six study sites. We anticipate that the characteristics of this
        population will vary by site, given the differences in patient populations served by each
        of the participating hospitals. Overall, we expect that cases will have the following
        demographic characteristics: 28% female; 14% Hispanic; 24% Black, 37% White, 1% Asian, 38%
        mixed race/other; 4% age 18-25, 33% age 26-45, 55% age 46-65, 7% >65 years.