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JMIR Res Protoc. 2013 Aug 02;2(2):e26. doi: 10.2196/resprot.2678.

Psychosocial interventions for alcohol use among problem drug users: protocol for a feasibility study in primary care.

JMIR research protocols

Jan Klimas, Rolande Anderson, Margaret Bourke, Gerard Bury, Catherine Anne Field, Eileen Kaner, Rory Keane, Eamon Keenan, David Meagher, Brian Murphy, Clodagh Sm O'Gorman, Thomas P O'Toole, Jean Saunders, Bobby P Smyth, Colum Dunne, Walter Cullen

Affiliations

  1. Centre for Interventions in Infection, Immunity and Inflammation (4i) and Graduate Entry Medical School, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland.

PMID: 23912883 PMCID: PMC3742410 DOI: 10.2196/resprot.2678

Abstract

BACKGROUND: Alcohol use is an important issue among problem drug users. Although screening and brief intervention (SBI) are effective in reducing problem alcohol use in primary care, no research has examined this issue among problem drug users.

OBJECTIVE: The objective of this study is to determine if a complex intervention including SBI for problem alcohol use among problem drug users is feasible and acceptable in practice. This study also aims to evaluate the effectiveness of the intervention in reducing the proportion of patients with problem alcohol use.

METHODS: Psychosocial intervention for alcohol use among problem drug users (PINTA) is a pilot feasibility study of a complex intervention comprising SBI for problem alcohol use among problem drug users with cluster randomization at the level of general practice, integrated qualitative process evaluation, and involving general practices in two socioeconomically deprived regions. Practices (N=16) will be eligible to participate if they are registered to prescribe methadone and/or at least 10 patients of the practice are currently receiving addiction treatment. Patient must meet the following inclusion criteria to participate in this study: 18 years of age or older, receiving addiction treatment/care (eg, methadone), or known to be a problem drug user. This study is based on a complex intervention supporting SBI for problem alcohol use among problem drug users (experimental group) compared to an "assessment-only" control group. Control practices will be provided with a delayed intervention after follow-up. Primary outcomes of the study are feasibility and acceptability of the intervention to patients and practitioners. Secondary outcome includes the effectiveness of the intervention on care process (documented rates of SBI) and outcome (proportion of patients with problem alcohol use at the follow-up). A stratified random sampling method will be used to select general practices based on the level of training for providing addiction-related care and geographical area. In this study, general practitioners and practice staff, researchers, and trainers will not be blinded to treatment, but patients and remote randomizers will be unaware of the treatment.

RESULTS: This study is ongoing and a protocol system is being developed for the study. This study may inform future research among the high-risk population of problem drug users by providing initial indications as to whether psychosocial interventions for problem alcohol use are feasible, acceptable, and also effective among problem drug users attending primary care.

CONCLUSIONS: This is the first study to examine the feasibility and acceptability of complex intervention in primary care to enhance alcohol SBI among problem drug users. Results of this study will inform future research among this high-risk population and guide policy and service development locally and internationally.

Keywords: alcohol; brief intervention; complex intervention; general practice; methadone maintenance; primary health care; screening; substance-related disorders

References

  1. J Subst Abuse Treat. 2010 Jul;39(1):58-64 - PubMed
  2. Addiction. 2012 Sep;107(9):1601-11 - PubMed
  3. BMC Med Res Methodol. 2010 Jan 06;10:1 - PubMed
  4. AIDS Patient Care STDS. 2010 Dec;24(12):753-62 - PubMed
  5. Drug Alcohol Depend. 2009 Apr 1;101(1-2):124-7 - PubMed
  6. J Eval Clin Pract. 2004 May;10(2):307-12 - PubMed
  7. Br J Gen Pract. 2006 Nov;56(532):848-56 - PubMed
  8. BMC Fam Pract. 2009 Apr 21;10:25 - PubMed
  9. BMJ. 1998 Oct 31;317(7167):1168-9 - PubMed
  10. Ir Med J. 2001 Jan;94(1):25-6 - PubMed
  11. Clin Teach. 2012 Jun;9(3):158-63 - PubMed
  12. Br J Gen Pract. 2000 Jul;50(456):546-9 - PubMed
  13. J Subst Abuse Treat. 2010 Sep;39(2):114-23 - PubMed
  14. BMC Med Res Methodol. 2010 Jul 16;10:67 - PubMed
  15. Drug Alcohol Depend. 2008 Dec 1;98(3):235-40 - PubMed
  16. Psychol Addict Behav. 2011 Jun;25(2):206-14 - PubMed
  17. Drug Alcohol Rev. 2009 May;28(3):301-23 - PubMed
  18. Cochrane Database Syst Rev. 2012 Nov 14;11:CD009269 - PubMed
  19. JMIR Res Protoc. 2013 Jan 23;2(1):e6 - PubMed
  20. BMC Public Health. 2009 Aug 10;9:287 - PubMed
  21. J Stud Alcohol. 2004 Mar;65(2):191-9 - PubMed
  22. Ir J Med Sci. 2003 Jul-Sep;172(3):123-7 - PubMed
  23. BMJ. 2013 Jan 09;346:e8501 - PubMed
  24. Drug Alcohol Rev. 2012 May;31(3):348-56 - PubMed
  25. J Am Podiatr Med Assoc. 2001 Sep;91(8):437-42 - PubMed
  26. Drug Alcohol Depend. 2010 Feb 1;107(1):23-30 - PubMed
  27. JMIR Res Protoc. 2012 May 23;1(1):e4 - PubMed
  28. Ir J Med Sci. 2012 Jun;181(2):165-70 - PubMed
  29. Ir Med J. 2000 Oct;93(7):214-7 - PubMed
  30. BMJ. 2000 Sep 16;321(7262):694-6 - PubMed
  31. J Med Internet Res. 2011 Dec 31;13(4):e126 - PubMed
  32. Cochrane Database Syst Rev. 2007 Apr 18;(2):CD004148 - PubMed
  33. Health Psychol. 2004 Sep;23(5):443-51 - PubMed
  34. Br J Addict. 1991 Mar;86(3):327-34 - PubMed
  35. BMC Fam Pract. 2009 Jun 11;10:42 - PubMed
  36. Addiction. 2013 Jun;108(6):1145-57 - PubMed
  37. Addiction. 1998 Dec;93(12):1857-67 - PubMed

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