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- Title
Does training in motivational interviewing for community pharmacists improve outcomes for methadone patients? A cluster randomised controlled trial.
- Authors
Jaffray, Mariesha; Matheson, Catriona; Bond, Christine M.; Lee, Amanda J.; McLernon, David J.; Johnstone, Allan; Skea, Lucy; Davidson, Bruce
- Abstract
Objectives Feasibility of pharmacist delivered motivational interviewing ( MI) to methadone patients has been demonstrated, but its efficacy is untested. This study aimed to determine whether pharmacists trained in MI techniques can improve methadone outcomes. Methods A cluster randomised controlled trial by pharmacy, with community pharmacies across Scotland providing supervised methadone to >10 daily patients, aged >18 years, started on methadone <24 months. Pharmacies were randomised to intervention or control. Intervention pharmacists received MI training and a resource pack. Control pharmacists continued with normal practice. Primary outcome was illicit heroin use. Secondary outcomes were treatment retention, substance use, injecting behaviour, psychological/physical health, treatment satisfaction and patient feedback. Data were collected via structured interviews at baseline and 6 months. Key findings Seventy-six pharmacies recruited 542 patients (295 intervention, 247 control), mean age 32 years; 64% male; 91% unemployed; mean treatment length 9 months. No significant difference in outcomes between groups for illicit heroin use (32.4% cf. 31.4%), although within-groups use reduced ( P < 0.001); treatment retention was higher in the intervention group but not significantly (88% cf. 81%; P = 0.34); no significant difference between groups in treatment satisfaction, although this improved significantly in intervention ( P < 0.05). More intervention than control patients said pharmacists had 'spoken more,' which approached statistical significance ( P = 0.06), and more intervention patients found this useful ( P < 0.05). Conclusions Limited intervention delivery may have reduced study power. The intervention did not significantly reduce heroin use, but there are indications of positive benefits from increased communication and treatment satisfaction.
- Subjects
SCOTLAND; MOTIVATIONAL interviewing; PHARMACISTS; SUBSTANCE abuse treatment; CLINICAL trials; COMMUNITIES; DRUGS of abuse; EMPLOYMENT; HEROIN; PATIENT aftercare; MEDICAL care; EVALUATION of medical care; METHADONE hydrochloride; PATIENTS; PHARMACOLOGY; DRUG abusers; HUMAN research subjects; PATIENT selection; EDUCATION
- Publication
International Journal of Pharmacy Practice, 2014, Vol 22, Issue 1, p4
- ISSN
0961-7671
- Publication type
Article
- DOI
10.1111/ijpp.12049