Lessons Learned for Follow-Up Booster Calls with ED Patients in the SMART-ED Trial

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boostercallThis article, by Pacific Northwest Node members Dennis Donovan, Mary Hatch-Maillette, Melissa Phares, and colleagues, looked at implementation issues related to providing brief motivational interviewing-based interventions over the phone as part of CTN protocol Screening, Motivational Assessment and Referral to Treatment in Emergency Departments (SMART-ED),” and includes challenges, “lessons learned,” and recommendations for others attempting to implement adjunctive booster call sessions.

In the study, attempts were made to complete two 20-minute telephone “booster” calls within a week following an emergency department (ED) patient’s discharge, with 425 patients who screened positive for and had recent problematic substance use (other than alcohol or nicotine).

Over half (56.2%) of participants completed the initial call; 66.9% of those who received the initial call also completed the second call. It took an average of 4 attempts for the first call to connect with participants and 3 for the second.  Each completed call lasted about 22 minutes.

Common challenges/barriers identified by booster callers included:

  • Unstable housing;
  • Limited phone access;
  • Unavailability due to additional treatment;
  • Lack of compensation for booster calls;
  • Booster calls coming from unrecognized numbers/area codes or someone other than ED staff (participants found this confusing and suspicious).

Conclusions:  A team of booster interventionists and supporting staff can overcome challenges in implementing a remotely located, centralized booster call center.  Specific recommendations are presented in the article with respect to overcoming barriers and challenges. Future research needs to evaluate the incremental benefit of adjunctive booster calls on outcomes over and above that of brief motivational interventions delivered in the emergency department setting.

Citation: Donovan DM, Hatch-Maillette MA, Phares MM, et al.  Lessons learned for follow-up phone booster counseling calls with substance abusing Emergency Department patients.  Journal of Substance Abuse Treatment 2014 (in press).


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