Multisite effectiveness trials of treatments for substance abuse and co-occurring problems: Have we chosen the best designs?

Edward V. Nunes, Samuel Ball, Robert Booth, Gregory Brigham, Donald A. Calsyn, Kathleen Carroll, Daniel J. Feaster, Denise Hien, Robert L. Hubbard, Walter Ling, Nancy M. Petry, John Rotrosen, Jeffrey Selzer, Maxine Stitzer, Susan Tross, Paul Wakim, Theresa Winhusen, George Woody

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

Multisite effectiveness trials such as those carried out in the National Drug Abuse Treatment Clinical Trials Network (CTN) are a critical step in the development and dissemination of evidence-based treatments because they address how such treatments perform in real-world clinical settings. As Brigham et al. summarized in a recent article (G. S. Brigham, D. J. Feaster, P. G. Wakim, & C. L. Dempsey C. L., 2009), several possible experimental designs may be chosen for such effectiveness trials. These include (a) a new treatment intervention (Tx) is compared to an existing mode of community based treatment as usual (TAU): Tx versus TAU; (b) a new intervention is added to TAU and compared to TAU alone: Tx + TAU versus TAU; or (c) a new intervention is added to TAU and compared to a control condition added to TAU: Tx + TAU versus control + TAU. Each of these designs addresses a different question and has different potential strengths and weaknesses. As of December 2009, the primary outcome paper had been published for 16 of the multisite randomized clinical trials conducted in the CTN, testing various treatments for drug abuse, HIV risk behavior, or related problems. This paper systematically examines, for each of the completed trials, the experimental design type chosen and its original rationale, the main findings of the trial, and the strengths and weaknesses of the design in hindsight. Based on this review, recommendations are generated to inform the design of future effectiveness trials on treatments for substance abuse, HIV risk, and other behavioral health problems.

Original languageEnglish (US)
Pages (from-to)S97-S112
JournalJournal of Substance Abuse Treatment
Volume38
Issue numberSUPPL. 1
DOIs
StatePublished - Jun 2010

Keywords

  • Clinical trial
  • Design
  • Drug
  • Effectiveness
  • HIV

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology
  • Phychiatric Mental Health
  • Medicine (miscellaneous)

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  • Cite this

    Nunes, E. V., Ball, S., Booth, R., Brigham, G., Calsyn, D. A., Carroll, K., Feaster, D. J., Hien, D., Hubbard, R. L., Ling, W., Petry, N. M., Rotrosen, J., Selzer, J., Stitzer, M., Tross, S., Wakim, P., Winhusen, T., & Woody, G. (2010). Multisite effectiveness trials of treatments for substance abuse and co-occurring problems: Have we chosen the best designs? Journal of Substance Abuse Treatment, 38(SUPPL. 1), S97-S112. https://doi.org/10.1016/j.jsat.2010.01.012