Personality traits and alcohol consumption: Secondary analysis of the Self-Match Study.

BACKGROUND: This secondary analysis of the Self-Match Study explores whether personality traits affect the treatment outcome for alcohol use disorders (AUD). We designed the Self-Match Study to investigate whether clients choosing between treatment options improves treatment outcomes. The primary outcome report revealed no difference in the outcome, whether treatment allocation was based on clinician matching or self-matching. Because willingness to choose, choice of treatment method, and compliance with treatment may be related to personality, this exploratory sub-study investigated the influence of personality traits on treatment outcome. METHOD: We enrolled 402 consecutive clients (female 46.7%, mean age 47.4) seeking treatment at the outpatient alcohol treatment center in Odense, Denmark. Clients were randomized to treatment by expert-match or self-matching. Data on alcohol consumption (Timeline Follow Back), personality traits (NEO-FFI-3), and retention in care were collected at baseline and 6-month follow-up. Outcomes were compliance, sensible drinking (alcohol intake below National Recommendations), and the number of heavy drinking days at follow-up. RESULTS: A high neuroticism score was negatively associated with treatment completion. Further, clients with a high score on neuroticism, openness, and extraversion, or a low score on conscientiousness were less likely to reduce their drinking to a sensible level at follow-up. We also found that low scores on conscientiousness were associated with having more heavy drinking days at follow-up. The personality traits neuroticism and openness were associated with treatment preferences. CONCLUSIONS: Personality traits influence 6 months drinking outcomes for people receiving AUD treatment.

The impact of free choice in alcohol treatment. Primary outcomes of the self-match study.

INTRODUCTION: A paternalistic approach to treatment planning is common, but there is a growing interest in involving clients in the planning of their own treatment, both in medical care and psychotherapy. Several studies on matching patients to treatment have failed to improve outcome. Studies on Shared Decision-Making in mental health are encouraging but somewhat ambiguous in addiction treatment. OBJECTIVE: This study investigated whether self-matching (Informed Choice) to treatment improves alcohol consumption, retention, and quality of life. METHOD: 402 consecutive clients (female 46.7 %, mean age 47.4) seeking treatment for alcohol use disorder at the outpatient clinic in Odense, Denmark were enrolled in this single-blinded randomized controlled trial. Clients randomized to the intervention group watched an 8-minute video presentation of the treatments and then chose the treatment they preferred. Clients in the treatment as usual (TAU) group were allocated to treatment by an evidence-based algorithm. Measurements on alcohol consumption, quality of life, and retention in care were completed at baseline and 6-month follow-up. RESULTS: There was no significant difference on primary and secondary outcome measures between the Informed Choice group and TAU group at 6-month follow-up. 80 % of clients in the Informed Choice group were satisfied with being randomized to self-matching whereas 24 % in the TAU group were satisfied with being assigned by expert matching. CONCLUSION: Our hypothesis, that outcome is improved if clients choose their own treatment, was not supported. However, an important finding is that client self-matching is just as beneficial as expert matching.

Is treatment outcome improved if patients match themselves to treatment options? Study protocol for a randomized controlled trial.

BACKGROUND: Research on matching patients to treatment has shown that matching grounded in expert views is little better than allocating patients by chance. Furthermore, there is growing emphasis on involving patients in their own treatment as a key to health behavior change. Research on the benefit of having patients choose their treatment from among options, in contrast to being assigned to a treatment by experts, has been limited. Consequently, we designed a rigorous test of patient self-matching to determine whether it does improve retention, adherence, and outcome in alcoholism treatment. METHODS/DESIGN: The present study is being conducted as a randomized controlled trial. Four hundred consecutive patients aged 18 years or older will be enrolled and randomized to either self-matching or expert-matching to one of five different treatment approaches. All patients entering the alcohol outpatient clinic in Odense are offered the opportunity to participate in the study. Exclusion criteria are cognitive dysfunction as measured with the Mini Mental State Examination, and non-Danish- or non-English-speaking individuals. The following instruments will be administered at intake to provide standardized measures of alcohol problems: the Addiction Severity Index, Timeline Followback, the World Health Organization quality of life questionnaire, the NEO Five-Factor Inventory 3, and the Personal Happiness Form. For each outcome measure, two analyses will be conducted. Intention-to-treat analyses (ITT) will be carried out with all patients, regardless of whether they complete the interventions or are reinterviewed. Regarding incomplete data, multiple imputations will be used together with ITT analysis. Completer analyses will also be carried out with patients who complete their respective interventions. The primary outcome is decrease in number of monthly excessive drinking days 6 months after initiation of treatment. Secondary outcomes are compliance and 2 quality of life. The influence of personality traits on outcome will also be examined in both groups. DISCUSSION: The debate on matching patients to treatment has been going on for decades. This study will cast light on this issue by focusing on patients' choice and thereby clarifying if patients' perceived autonomy yields better outcomes. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03278821 . Registered on 12 September 2017.

Is the Danish Version of MATE Feasible? A Pilot Study on Feasibility and Adequacy.

OBJECTIVE: Assessment is pivotal to the work of health care professionals and social workers, as it provides fundamental, systematic information that is essential when planning interventions. Many patients have addiction problems as well as psychiatric illness and they very often interact. An assessment tool addressing both areas would be beneficial for this large group of patients. This pilot study explores feasibility and adequacy of the Danish translation of the Measurements in Addiction for Triage and Evaluation (MATE) assessment in the following sectors: drug and alcohol treatment, psychiatry, and social service. METHODS: Thirty staff members from psychiatric hospital, social services, and treatment institutions for alcohol and substance abuse were recruited. Staff that had direct contact with clients were planned to perform at least two MATE interviews. RESULTS: Nineteen interviews were completed. Information gathered from MATE was reported to be adequate for making a triage decision, but psychiatric staff reported that MATE gathered too much irrelevant information, especially concerning daily life functioning. Overall feasibility was satisfactory, but staff and patients were at some points critical of wording, casting doubt on the understanding of some questions. CONCLUSIONS: This pilot study found that MATE gathers relevant and sufficient information in an appropriate amount of time.