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The aim of this clinical study is to evaluate the efficacy of reinforced inpatient aftercare versus usual care on the percentage of days of abstinence during the first year following withdrawal in adults with alcohol use disorders undergoing inpatient withdrawal. The hypothesis is that reinforced post-withdrawal follow-up, of the motivational interview type, during the first 4 months following hospitalisation, in addition to the usual care, would allow :
All participants will have assessments to monitor their abstinence and consumption. In addition to their assessments, the experimental group will have motivational talks once every 15 days.
In Europe, and particularly in France, there is a high level of alcohol consumption per capita (2.51 standard drinks/day/inhabitant in France in 2019). This consumption is not without risk, since 7% of all deaths in France in 2015 were attributable to alcohol, not to mention disabling pathologies and injuries. The treatment of alcohol addiction has many facets (social, neurological, psychological, behavioural, etc.) and involves a number of stages. One aspect that is particularly decisive in the consolidation phase of withdrawal (the phase following withdrawal when the risk of relapse is high) is the motivational dimension, which is widely described in the literature. Motivational Interviewing (MI) is a particularly effective tool for initiating and maintaining change. This tool, provided on a regular basis after discharge from hospital, helps to reinforce and maintain abstinence, a change initiated by users at the time of withdrawal.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Experimental group : PSH (usual care) with motivational interviewing | Experimental | People randomised to the experimental group will have scheduled appointments to collect study data (monthly assessment). They will take part in an initial motivational interview to lay the foundations for the work that will be carried out throughout the follow-up period. Then, for 4 and a half months, a motivational interview will be scheduled every 14 days. |
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| Control group : PSH (usual care) | No Intervention | People randomised to the control group will have scheduled appointments for study-related data collection (monthly assessment), in addition to their routine care. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Experimental group : PSH (usual care) with motivational interviewing | Other | The experimental group will begin follow-up after the 1st inclusion visit, during hospitalisation for withdrawal. The first motivational interview will take place 1 to 4 days before discharge from full hospitalisation. The following 10 motivational interviews will be held 2 weeks apart and will follow a framework based on the following objectives: to create a relationship of trust and an effective and lasting therapeutic alliance from the first interview; to create personalised objectives for the user, in line with their addictive pathology; to support the user as they modify, 'fail' and 'succeed' in achieving these objectives; to encourage the emergence and maintenance of the user's desire to change. |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of days of abstinence over the 12 months following hospitalization for alcohol | The measures used for our main criterion will be declarative and collected on paper and by telephone every month in terms of the number of drinks per day. To facilitate data collection, the Timeline Follow Back method [30], developed by Sobell and also validated by telephone, will be used. This tool enables estimates of daily consumption of standard glasses to be collected retrospectively (for up to 12 months). The advantage of this method is that it reduces recall bias, since the participant can fill in a calendar from day to day and the data are collected every month. | From inclusion,once a month for 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Relapse rates at 5 and 12 months | Percentage of patients who have relapsed (above WHO recommendations for low-risk drinking) at least once in the 5 and 12 months following hospitalisation for alcohol withdrawal. This relapse rate will be calculated on the basis of the consumption schedule collected using the method presented for the primary endpoint. As a reminder, the recommendations for lower-risk drinking are as follows:
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Thomas RISDORFER DE ISSDENTZI | Contact | 04 67 33 70 20 | +33 | t-risdorferdeissdentzi@chu-montpellier.fr |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Thomas RISDORFER DE ISSDENTZI | Recruiting | Montpellier | 3400 | France |
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| From inclusion,once a month for 1 year |
| Cumulative duration (in days) and maximum duration of abstinence over 5 and 12 months | These cumulative and maximum periods of abstinence will be based on the consumption calendar collected using the Timeline Follow Back method. | Assessed 5 months after inclusion and 12 months after inclusion |
| Motivation to maintain abstinence | Assessed using the Stages of Change Readiness and Treatment Eagerness Scale questionnaire | Assessed 0 month, 5 months and 12 months after inclusion |
| Craving felt | Assessed using the Obsessive Compulsive Drinking Scale | Assessed 0 month, 5 months and 12 months after inclusion |
| Effectiveness of coping strategies | Assessed using the Way og Coping Checklist questionnaire | Assessed 0 month, 5 months and 12 months after inclusion |
| Level of anxiety/depression | Assessed using the Hospital Anxiety and Depression scale questionnaire | Assessed 0 month, 5 months and 12 months after inclusion |
| Sense of personal effectiveness | Assessed using the Sherer General Self-Efficacy Scale | Assessed 0 month, 5 months and 12 months after inclusion |
| Use of other substances | Collection of data declarative data on consumption and quantification in the previous month | Assessed 0 month, 5 months and 12 months after inclusion |
| ID | Term |
|---|---|
| D000437 | Alcoholism |
| D016739 | Behavior, Addictive |
| D012008 | Recurrence |
| ID | Term |
|---|---|
| D019973 | Alcohol-Related Disorders |
| D019966 | Substance-Related Disorders |
| D064419 | Chemically-Induced Disorders |
| D001523 | Mental Disorders |
| D003192 | Compulsive Behavior |
| D007175 | Impulsive Behavior |
| D001519 | Behavior |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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