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LINKAGE increases patient engagement, communication in addiction treatment

The LINKAGE intervention effectively helped individuals receiving addiction treatment engage in health care and increase communication with their physicians, according to recent findings.

“Patients with [alcohol and other drug] disorders lag behind individuals with other health conditions in participating in their health care through patient portals, and few interventions to facilitate their use have been tested. At the same time, studies demonstrate the use of health technology by patients with [alcohol and other drug]and psychiatric disorders,” Constance M. Weisner, DrPH, LCSW, of University of California, San Francisco, and colleagues wrote. “Patient portals provide opportunities to engage in health care, such as interacting with clinicians, using online programs for health problems (eg, sleep disorders or coping with pain), and obtaining medical information and appointments.”

To determine efficacy of the LINKAGE intervention, which uses electronic health record and patient activation to engage individuals receiving addiction treatment with health care, researchers conducted a nonrandomized clinical trial among 503 individuals from an outpatient addiction treatment clinic. Study participants assigned to LINKAGE (n = 252) received six group-based, manual-guided sessions on patient engagement in health care and the use of health information technology resources in the electronic health record plus facilitated communication with physicians. Remaining participants (n = 251) received usual care. Participants had a mean age of 42.5 years. Researchers applied an alternating 3-month off-and-on design over 30 months.

Mean number of log-in days was higher among participants who received LINKAGE (IRR = 1.53; 95% CI, 1.19-1.97; P = .001), compared with those who received usual care.

Types of patient portal use, including communicating by email, viewing laboratory test results and information and obtaining medical advice, were also higher among LINKAGE participants vs. usual care participants.

Participants who received LINKAGE were more likely to talk with their physicians about addiction problems (OR = 2.3; 95% CI, 1.52-3.49; P < .001).

Six-month abstinence rates were greater than 70% for both conditions.

Depression symptoms also improved among all participants.

Alcohol and other drug outcomes were significantly better among participants who received all intervention components than those who received fewer components.

“Teaching patients receiving addiction treatment how to use health care may empower them to better engage in their health management. Electronic health record patient portals may be useful in accomplishing this goal,” the researchers wrote. “Although the LINKAGE intervention did not achieve short-term differences in [alcohol and other drug] and depression outcomes, it will be important to understand if it is helpful in avoiding [alcohol and other drug] relapse and in improving overall health.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.