Jan Grycynski

FRI Researcher Receives New R01 Award

FRI is pleased to announce that Jan Gryczynski, along with Co-Investigators Drs. Robert SchwartzShannon Gwin Mitchell, and Christopher Welsh have received a grant award from the National Institute on Drug Abuse entitled “Navigation Services to Avoid Rehospitalization (NavSTAR) among substance users.” In recent years, the problem of repeat hospitalization has come under intense focus as a contributor to preventable morbidity and escalating healthcare costs. Substance use disorders (SUDs) are strongly associated with poor health outcomes and inefficient use of healthcare services, including repeat hospitalizations. Interventions that increase adherence to recommendations for outpatient medical care and SUD treatment could potentially help recently-hospitalized individuals to avoid unnecessary rehospitalization, associated morbidity, and medical expenses. This study is a randomized controlled trial comparing the effectiveness of Navigation Services to Avoid Rehospitalization (NavSTAR) vs. Treatment-as-Usual (TAU) for hospital patients with co-occurring medical problems and SUDs. Applying Andersen’s theoretical model of health service utilization, NavSTAR uses a small dedicated team to deliver the promising strategies of Patient Navigation and motivational interventions for hospital patients post-discharge, with the goal of facilitating engagement in outpatient medical and SUD treatment. Patient Navigators embedded within the substance abuse consultation liaison service at a large urban hospital will deliver patient-centered, proactive navigation and motivational services initiated during the hospital stay and continued for 3 months post-discharge. Participants randomized to TAU will receive usual care from the hospital and the substance abuse consultation liaison service. Participants will be assessed at study entry and again at 3-, 6-, and 12-months follow-up on various measures of healthcare utilization, substance use, and functioning. The primary outcome of interest is rehospitalization through 12 months. In addition, a range of secondary outcomes spanning domains of individual health, functioning, and service utilization will be assessed. The study will include an economic evaluation of NavSTAR from the service provider perspective. If NavSTAR proves to be effective and cost-effective in reducing rehospitalizations and improving outcomes in this high-risk patient group, it would have important implications for designing hospital discharge planning services, informing national cost containment initiatives, and improving public health.