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Chronic care management programme is no more effective than usual primary care at increasing abstinence among people with alcohol or substance dependency

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Question: Does chronic care management (CCM) improve substance use outcomes compared with usual primary care among people with alcohol and other substance dependence?

Patients: 563 adults (aged over 18 years) with a diagnosis of alcohol or other substance dependence. Alcohol dependence was assessed using the Composite International Diagnostic Interview Short Form (CIDI-SF), with heavy drinking in the past 30 days defined as ≥5 drinks on one occasion at least twice per week or ≥22 drinks per average week in men (≥4 and ≥15 drinks, respectively, in women). Substance dependence was also assessed using the CIDI-SF, and included use of psychostimulants (cocaine, methamphetamine or prescription amphetamine), heroin or prescription opioids, with misuse defined as use without a prescription, or in larger amounts or for longer duration than prescribed.

Setting: A hospital-based primary care practice in Boston, USA from 2006 to 2009.

Intervention: CCM versus control of a primary care appointment with no CCM. CCM consisted of longitudinal care coordinated with a primary care physician; motivational enhancement therapy; …

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