The majority of patients with alcohol problems present to general medical and other clinical settings, rather than directly to alcohol treatment. The consequences of untreated alcohol problems are well known, and include a whole range of medical and social complications. The identification and treatment of alcohol problems, when patients present for prenatal care, emergency services, or a medical appointment, has been a longstanding clinical research interest. A Midcareer Investigator Award in Clinical Research would allow the applicant to focus on patient-oriented research interests during a critical professional period. The purpose of the current project, """"""""Alcohol Abuse in Bone Marrow Transplant,"""""""" is to test the hypothesis that alcohol abuse or dependence has an adverse impact on survival after bone marrow transplant, the second most frequent major organ transplant in the United States and the transplant with the least limited donor organ supply. A prospective cohort study of 124 patients with Chronic Myeloid Leukemia undergoing allogeneic bone marrow transplant is underway. The purpose of the proposed project, """"""""Alcohol Screening in Medicaid Managed Care,"""""""" is to test the hypothesis that routine alcohol and substance abuse screening of Medicaid members at health plan (HMO) enrollment is less effective than alcohol and substance abuse screening at the HMO primary care site. A sample of 2,000 Medicaid enrollees screened at enrollment will compared with a sample of 715 patients who will be screened for alcohol and substance abuse as they initiate care at primary care HMO sites. Their utilization of alcohol and substance abuse treatment, psychiatric and medical treatment for 12 months subsequent to screening will be compared. A sample of 150 patients with positive primary care screens will be studied more intensively. Both of these studies will focus on patients, but will have important practice and policy implications, as transplant medicine and managed care are increasingly prevalent and underscore the need for alcohol and drug screening of patients.

Agency
National Institute of Health (NIH)
Institute
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Type
Midcareer Investigator Award in Patient-Oriented Research (K24)
Project #
5K24AA000289-02
Application #
6168168
Study Section
Health Services Research Review Subcommittee (AA)
Project Start
1999-09-24
Project End
2004-08-31
Budget Start
2000-09-01
Budget End
2001-08-31
Support Year
2
Fiscal Year
2000
Total Cost
$116,100
Indirect Cost
Name
Brigham and Women's Hospital
Department
Type
DUNS #
071723621
City
Boston
State
MA
Country
United States
Zip Code
02115
Fisher, Naomi Deirdre Lakshmi; Orav, Endel John; Chang, Grace (2018) Effects of alcohol consumption on blood pressure in hypertensive women. Am J Drug Alcohol Abuse 44:200-205
Chang, Grace; Weiss, Anthony P; Orav, Endel John et al. (2014) Predictors of frequent emergency department use among patients with psychiatric illness. Gen Hosp Psychiatry 36:716-20
Chang, Grace; Meadows, Mary-Ellen; Smallwood, Jennifer A et al. (2014) Cognitive and other predictors of change in quality of life one year after treatment for chronic myelogenous leukemia or myelodysplastic syndrome. J Neuropsychiatry Clin Neurosci 26:249-57
Rossi, Brooke V; Chang, Grace; Berry, Katharine F et al. (2013) In vitro fertilization outcomes and alcohol consumption in at-risk drinkers: the effects of a randomized intervention. Am J Addict 22:481-5
Weiss, Anthony; Schechter, Mark; Chang, Grace (2013) Case management for frequent emergency department users. Psychiatr Serv 64:715-6
DeMarinis, Valerie; Caplan, Jason; Chang, Grace (2013) Brief intervention for risk-drinking women: a mixed methods analysis of content and process. Am J Addict 22:67-74
Kroll, David S; Smallwood, Jennifer; Chang, Grace (2013) Drug screens for psychiatric patients in the emergency department: evaluation and recommendations. Psychosomatics 54:60-6
Meadows, Mary-Ellen; Chang, Grace; Jones, Jennifer A et al. (2013) Predictors of neuropsychological change in patients with chronic myelogenous leukemia and myelodysplastic syndrome. Arch Clin Neuropsychol 28:363-74
Chang, Grace; Pomahac, Bohdan (2013) Psychosocial changes 6 months after face transplantation. Psychosomatics 54:367-71
Chang, Grace; Weiss, Anthony; Kosowsky, Joshua M et al. (2012) Characteristics of adult psychiatric patients with stays of 24 hours or more in the emergency department. Psychiatr Serv 63:283-6

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