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. 2017 Jan-Apr;17(1):9-19.
doi: 10.1016/j.ijchp.2016.05.001. Epub 2016 Jul 2.

Motivational enhancement treatment in outpatient addiction centers: A multisite randomized trial

Rodrigo Marín-Navarrete  1 , Viviana E Horigian  2 , María Elena Medina-Mora  1 , Rosa E Verdeja  2 , Elizabeth Alonso  2 , Daniel J Feaster  2 , José Fernández-Mondragón  1 , Carlos Berlanga  1 , Ricardo Sánchez-Huesca  3 , Carlos Lima-Rodríguez  4 , Ana De la Fuente-Martín  1
Affiliations

Motivational enhancement treatment in outpatient addiction centers: A multisite randomized trial

Rodrigo Marín-Navarrete et al. Int J Clin Health Psychol. 2017 Jan-Apr.

Abstract
in English, Spanish

Background/objectives: Motivational Enhancement Treatment in Spanish (METS) is a brief intervention aimed at resolving patient ambivalence towards behavior change that has demonstrated efficacy in substance use disorder treatment to reduce use and increase treatment engagement in different populations. In order to have evidence for its implementation in Mexico, a multi-site, randomized, two-arm, controlled clinical trial was conducted at three outpatient addiction treatment centers in the country to compare the effect of METS with Counseling as Usual (CAU).

Method: One hundred and twenty patients were randomized to receive three sessions of METS (n = 54) or CAU (n = 66) during the first four weeks of treatment and were assessed during the following 12 weeks. Primary outcome measures were self-reported days of substance use and of treatment services utilization, which were tested using Generalized Estimating Equations.

Results: Results associated both conditions with significant changes in substance use over, whereas there were no differences between conditions in substance use or in service utilization.

Conclusions: Findings do not support the hypothesis that METS is more effective than CAU, but suggest that brief interventions at treatment initiation may improve patient outcomes.

Antecedentes/Objetivos: La Intervención de Incremento Motivacional (METS) es una intervención breve para resolver la ambivalencia del paciente con respecto a su comportamiento y ha demostrado eficacia en distintas poblaciones para reducir el consumo de sustancias e incrementar la asistencia al tratamiento en adicciones. Con el objetivo de generar evidencia para su implementación en México, se desarrolló un ensayo clínico controlado, multi-sede, aleatorizado, de dos brazos en tres centros de tratamiento ambulatorio para adicciones, para comparar el efecto de METS con el del tratamiento usual (CAU). Método: Ciento veinte pacientes fueron aleatorizados a tres sesiones de METS (n = 54) o CAU (n = 66) durante las primeras cuatro semanas de tratamiento y evaluados durante las siguientes doce. Se midieron resultados mediante autoinforme de días con consumo de sustancias y días de utilización de servicios, los cuales fueron analizados mediante ecuaciones de estimación generalizadas. Resultados: Los resultados asociaron ambas condiciones a cambios significativos en uso de sustancias a lo largo del tiempo, pero no demostraron diferencias entre condiciones en el uso de sustancias o en la utilización de servicios. Conclusiones: Los hallazgos contradicen la hipótesis de superioridad de METS sobre CAU, pero sugieren que las intervenciones breves al inicio del tratamiento pudieran mejorar la respuesta del paciente.

Keywords: Evidence-based practice; Experimental trial; Motivational interviewing; México; Substance use disorder.

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Figures

Figure 1
Figure 1
CONSORT Diagram. Participant recruitment and randomization. Note. CAU = Conuselling as Usual; METS = Motivational Enhancement Treatment (Spanish).
Figure 2
Figure 2
Mean days of any substance use by time Treatment condition by Time (as phase) interaction for 28 days of any substance use at 28 days (Active Phase) (1), 8-weeks (2), 12 weeks (3) and 16 weeks (4) after randomization.Note. CAU = Counseling as Usual, METS = Motivational Enhancement Treatment (Spanish).
See this image and copyright information in PMC

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