A stepped wedge cluster randomised trial of a cognitive remediation intervention in alcohol and other drug (AOD) residential treatment services

Jamie Berry; Isabella Jacomb; Jo Lunn; Antoinette Sedwell; Anthony Shakeshaft; Peter J. Kelly; Pooria Sarrami; Megan James; Skye Russell; Talia Nardo; Daniel Barker; Jennifer Holmes

doi:10.1186/s12888-019-2044-4

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A stepped wedge cluster randomised trial of a cognitive remediation intervention in alcohol and other drug (AOD) residential treatment services

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A stepped wedge cluster randomised trial of a cognitive remediation intervention in alcohol and other drug (AOD) residential treatment services

Jamie Berry, Isabella Jacomb, Jo Lunn, Antoinette Sedwell, Anthony Shakeshaft, Peter J. Kelly, Pooria Sarrami, Megan James, Skye Russell, Talia Nardo, …

BMC Psychiatry, Vol.19, pp.1-11

2019

DOI: https://doi.org/10.1186/s12888-019-2044-4

PMID: 30760250

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Abstract

Cognitive rehabilitation

Cognitive remediation

Alcohol and drug

Executive function

Treatment retention

Goal setting

Background Executive functioning impairment is common in substance use disorder and is a major risk factor for poor treatment outcomes, including treatment drop-out and relapse. Cognitive remediation interventions seek to improve executive functioning and offer a promising approach to increase the efficacy of alcohol and other drug (AOD) treatments and improve long-term therapeutic outcomes. This protocol describes a study funded by the NSW Agency for Clinical Innovation that assesses the effectiveness of delivering a six-week group-based intervention of cognitive remediation in an ecologically valid sample of people attending residential AOD treatment services. We primarily aim to investigate whether cognitive remediation will be effective in improving executive functioning and treatment retention rates. We will also evaluate if cognitive remediation may reduce long-term AOD use and rates of health service utilisation, as well as improve personal goal attainment, quality of life, and client satisfaction with treatment. In addition, the study will involve an economic analysis of the cost of delivering cognitive remediation. Methods/design The study uses a stepped wedge cluster randomised design, where randomisation will occur at the cluster level. Participants will be recruited from ten residential AOD treatment services provided by the non-government sector. The intervention will be delivered in 12 one-hour group-based sessions over a period of six weeks. All participants who are expected to receive treatment for the duration of the six-week intervention will be asked to participate in the study. The clusters of participants who are randomly assigned to the treatment condition will complete cognitive remediation in addition to treatment as usual (TAU). Primary and secondary outcome assessments will be conducted at pre-cognitive remediation/TAU phase, post-cognitive remediation/TAU phase, two-month follow-up, four-month follow-up, six-month follow-up, and eight-month follow-up intervals. Discussion This study will provide comprehensive data on the effect of delivering a cognitive remediation intervention within residential AOD treatment services. If shown to be effective, cognitive remediation may be incorporated as an adjunctive intervention in current treatment programs. Trial registration Australian and New Zealand Clinical Trials Register (ANZCTR): ACTRN12618001190291. Prospectively registered 17th July 2018.

Details

Title: A stepped wedge cluster randomised trial of a cognitive remediation intervention in alcohol and other drug (AOD) residential treatment services
Authors: Jamie Berry - Macquarie University
Isabella Jacomb - Macquarie University
Jo Lunn - We Help Ourselves (Australia)
Antoinette Sedwell - NSW Agency for Clinical Innovation -St Leonards, Australia (ACI)
Anthony Shakeshaft - UNSW Sydney
Peter J. Kelly - University of Wollongong
Pooria Sarrami - UNSW Sydney
Megan James - NSW Agency for Clinical Innovation -St Leonards, Australia (ACI)
Skye Russell - NSW Agency for Clinical Innovation -St Leonards, Australia (ACI)
Talia Nardo (Corresponding Author) - Macquarie University
Daniel Barker - University of Newcastle Australia
Jennifer Holmes - New South Wales Department of Health
Publication details: BMC Psychiatry, Vol.19, pp.1-11
Publisher: BioMed Central Ltd.
Date published: 2019
DOI: 10.1186/s12888-019-2044-4
ISSN: 1471-244X
PMID: 30760250
Copyright note: This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Data Availability: Not applicable.
Grant note: This study is funded by the Drug and Alcohol Network of the Agency for Clinical Innovation.
Organisation Unit: School of Health - Psychology
Language: English
Record Identifier: 991241462902621
Output Type: Journal article

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