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Alcohol use disorder (AUD) affects between 4% and 6% of French adults, and requires appropriate medical treatment.
However, 20-40% of patients with AUD are lost to follow-up at an early stage. Consequently, it is important for addiction departments to implement and evaluate innovative tools and interventions, including the involvement of peer support, to help patients remain in care, and to assess whether peer support has a positive impact on their clinical outcome.
Addiction peer support specialists (APSSs) are individuals who have personally experienced addiction, and who have decided to use their experience to assist other people going through a similar situation, after completing a specific official graduation.
Compared to other caregivers, APSSs may induce in patients a sense of identification which could improve the patient motivation to engage and remain in care.
This is the main hypothesis and the main scientific objective of the PEERSIAD study, which will aim to confirm that accompanying patients with AUD using APSSs after alcohol detoxification, reduces the rate of lost-to-follow-up and improves the overall clinical outcome.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Peer support Group | Experimental | 313 patients will be recruited over 3 years in the peer support group. Patients will be accompanied by an addiction peer support specialist, as part of an "add-on" follow-up compared with conventional follow-up (same management as in the control group). |
|
| Control Group | Active Comparator | 313 patients will be recruited over 3 years in the control group. Patients will receive "as usual" outpatient abstinence-maintenance follow-up, with consultations of all kinds (medical, psychological, nursing, group, etc.) |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Quality life questionnaire AQoLS | Behavioral | Quality life questionnaire AQoLS will be completed by patients of both arms at inclusion, three and six months after inclusion |
|
| Measure | Description | Time Frame |
|---|---|---|
| Unplanned cessation of care at 6 months | The unplanned cessation of care at 6 months, excluding consultations with an APSS, with no further contact in the following month, is defined as having had a last planned consultation that was not fulfilled between M0 and M6 | At 6 months after inclusion |
| Measure | Description | Time Frame |
|---|---|---|
| Number of unfulfilled consultations | The number of unfulfilled consultations (scheduled consultations, excluding Peer Support consultations, without patient's visit with or without justification) over the 6-month study follow-up period, collected from the medical records of the addictology department. | 6 months after inclusion |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Benjamin ROLLAND, Professor | Contact | 04 37 91 50 75 | +33 | Benjamin.ROLLAND@chu-lyon.fr |
| Nathalie Perreton | Contact | 04 27 85 63 04 | +33 | nathalie.perreton@chu-lyon.fr |
| Name | Affiliation | Role |
|---|---|---|
| Benjamin ROLLAND | Hopsices Civils de Lyon | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CH Le Vinatier | Bron | 69500 | France |
|
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| ID | Term |
|---|---|
| D000437 | Alcoholism |
| D016739 | Behavior, Addictive |
| ID | Term |
|---|---|
| D019973 | Alcohol-Related Disorders |
| D019966 | Substance-Related Disorders |
| D064419 | Chemically-Induced Disorders |
| D001523 | Mental Disorders |
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| Quality life questionnaire Euroqol EQ-5D-5L | Behavioral | Quality life questionnaire Euroqol EQ-5D-5L will be completed by patients of both arms at inclusion, three and six months after inclusion |
|
| Peer support consultations | Other | For patients included in the Peer support group, eight mandatory consultations with a peer support specialist will be performed between the inclusion visit and during the three following months. Patients can request additional consultations with the peer support specialist during the 6 first months of follow-up |
|
| Euroqol-5D-5L questionnaire score |
The differential cost-utility ratio, in relation to the innovative strategy including a Peer Support, will be assessed using the Euroqol-5D-5L questionnaire (EQ-5D-5L). |
| At inclusion, 3 and 6 months after inclusion |
| Difference in costs (in euros) | An additional analysis will be carried out if the cost-utility ratio is positive: Difference in costs (in euros) for the payer (French compulsory health insurance) between a scenario in which the innovative management is implemented and disseminated in practice and on French territory, and a scenario in which usual follow-up is maintained. | At 1, 2 and 3 years after the beginning of implementation on French territory |
| Number of AUD criteria according to Diagnostic and Statistical Manual of Mental Disorders (DSM-5) | At inclusion, 3 and 6 months after inclusion |
| Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) score | At inclusion, 3 and 6 months after inclusion |
| average number of standard drinks declared per week | At inclusion, 3 and 6 months after inclusion |
| Alcohol Quality of Life Scale (AQoLS) score | Changes in quality of life will be measured using the AQoLS | At inclusion, 3 and 6 months after inclusion |
| State-Trait Anxiety Inventory (STAI-Y) score | Changes in levels of anxiety will be measured using STAI-Y | At inclusion, 3 and 6 months after inclusion |
| Montgomery-Åsberg Depression Rating Scale (MADRS) score | Changes in levels of depression will be measured using MADRS | At inclusion, 3 and 6 months after inclusion |
| Cannabis Use Disorders Identification Test - Revised (CUDIT-R) score | Changes in the severity of cannabis use will be measured by the CUDIT-R score | At inclusion, 3 and 6 months after inclusion |
| type of opioid use | At inclusion, 3 and 6 months after inclusion |
| frequency of opioid use | At inclusion, 3 and 6 months after inclusion |
| type of psychostimulant use | At inclusion, 3 and 6 months after inclusion |
| frequency of psychostimulant use | At inclusion, 3 and 6 months after inclusion |
| Fagerström test score | Tobacco use will be measured by the Fagerström test | At inclusion, 3 and 6 months after inclusion |
| Health Care Satisfaction Questionnaire (HCSQ) score | Patient's satisfaction will be measured by HCSQ questionnaire | At 6 months after inclusion |
| Number of hospitalisations | Measurement of the number of hospitalisations related or not to the AUD and the ratio of total hospital days to number of hospital admissions (based on medical records and patient interviews) | At 6 months after inclusion |
| Service organization description | Before setting up of the study |
| Description of type of support and missions performed by Peer Support | After last visit of last patient (around 3,5 years after first inclusion) |
| Acceptability of Intervention Measure (AIM) score | AIM score measured in Peer Support and medical staff | After last visit of last patient (around 3,5 years after first inclusion) |
| AIM score | AIM score measured in patients | At 6 months after inclusion |
| Adoption of intervention | adoption of intervention will be assessed through semi-structured interviews and measurement of the number of patients followed-up versus the number of eligible patients, refusals to be accompanied by APSS, and premature discontinuation of follow-up | After last visit of last patient (around 3,5 years after first inclusion) |
| Intervention fidelity | intervention fidelity will be assessed by monitoring APSS activity indicators, describing deviations from the protocol and semi-structured interviews | After last visit of last patient (around 3,5 years after first inclusion) |
| Hôpital Beaujon | Clichy | 92110 | France |
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| GH Nord, Hospices Civils de Lyon | Lyon | 69004 | France |
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| CHS St Anne | Paris | 75014 | France |
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| Bichat Hospital | Paris | 75018 | France |
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| D003192 | Compulsive Behavior |
| D007175 | Impulsive Behavior |
| D001519 | Behavior |