TY - JOUR
T1 - The acceptability and feasibility of a brief psychosocial intervention to reduce blood-borne virus risk behaviours among people who inject drugs: a randomised control feasibility trial of a psychosocial intervention (the PROTECT study) versus treatment as usual
AU - Gilchrist, Gail
AU - Swan, Davina
AU - Shaw, April
AU - Keding, Ada
AU - Towers, Sarah
AU - Craine, Noel
AU - Munro, Alison
AU - Hughes, Elizabeth
AU - Parrott, Steve
AU - Strang, John
AU - Taylor, Avril
AU - Watson, Judith M
N1 - Funding Information:
This project was funded by the National Institute for Health Research Health Technology Assessment programme (project number 13/17/04). The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the Health Technology Assessment programme, NIHR, NHS or the Department of Health.
Funding Information:
We are grateful to the staff and service users at the substance use treatment services where the study took place. We would like to thank officers and research nurses from the Clinical Research Network: South London (Michael Kelly and Amy McLachlan), York Teaching Hospitals NHS Trust (Christopher Rhymes, Andy Gibson, Monica Wright and Zoe Coleman) and Clinical Research Network: Wales (Lynda Sackett) for their help with recruitment and assessment of participants to the feasibility trial. We would also like to thank Zoe Richardson (University of York) for conducting the staff focus groups in York and for data entry, and Dr Martha Canfield (King’s College London) for assisting with the collection of outcome data for the feasibility trial in London. We would also like to thank the PROTECT intervention development group: Stephanie Brickwood, Archie Christian, Jon Derricott, John Dillon, Paul Donachy, Magdalena Harris, Paul Lennon, Martin McCusker, Luke Mitcheson, Danny Morris, Terry Shields, Josie Smith, Carla Treloar and Jason Wallace. This manuscript presents independent research funded by the National Institute for Health Research (NIHR) under the Health Technology Assessment programme [project number 13/17/04]. The findings from this review will also be published as part of the full project report “Preventing blood borne virus infection in people who inject drugs in the UK: the development and feasibility of psychosocial interventions” in Health Technology Assessment. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.
PY - 2017/3/21
Y1 - 2017/3/21
N2 - BackgroundWhile opiate substitution therapy and injecting equipment provision (IEP) have reduced blood-borne viruses (BBV) among people who inject drugs (PWID), some PWID continue to share injecting equipment and acquire BBV. Psychosocial interventions that address risk behaviours could reduce BBV transmission among PWID.MethodsA pragmatic, two-armed randomised controlled, open feasibility study of PWID attending drug treatment or IEP in four UK regions. Ninety-nine PWID were randomly allocated to receive a three-session manualised psychosocial group intervention and BBV transmission information booklet plus treatment as usual (TAU) (n = 52) or information booklet plus TAU (n = 47). The intervention was developed from evidence-based literature, qualitative interviews with PWID, key stakeholder consultations, and expert opinion. Recruitment rates, retention in treatment, follow-up completion rates and health economic data completion measured feasibility.ResultsFifty-six percent (99/176) of eligible PWID were recruited. More participants attended at least one intervention session in London (10/16; 63%) and North Wales (7/13; 54%) than in Glasgow (3/12; 25%) and York (0/11). Participants who attended no sessions (n = 32) compared to those attending at least one (n = 20) session were more likely to be homeless (56 vs 25%, p = 0.044), injected drugs for a greater number of days (median 25 vs 6.5, p = 0.019) and used a greater number of needles from an IEP in the last month (median 31 vs 20, p = 0.056). No adverse events were reported. 45.5% (45/99) were followed up 1 month post-intervention. Feedback forms confirmed that the intervention was acceptable to both intervention facilitators and participants who attended it. Follow-up attendance was associated with fewer days of injecting in the last month (median 14 vs 27, p = 0.030) and fewer injections of cocaine (13 vs 30%, p = 0.063). Analysis of the questionnaires identified several service use questionnaire categories that could be excluded from the assessment battery in a full-randomised controlled trial.ConclusionsFindings should be interpreted with caution due to small sample sizes. A future definitive RCT of the psychosocial intervention is not feasible. The complex needs of some PWID may have limited their engagement in the intervention. More flexible delivery methods may have greater reach.
AB - BackgroundWhile opiate substitution therapy and injecting equipment provision (IEP) have reduced blood-borne viruses (BBV) among people who inject drugs (PWID), some PWID continue to share injecting equipment and acquire BBV. Psychosocial interventions that address risk behaviours could reduce BBV transmission among PWID.MethodsA pragmatic, two-armed randomised controlled, open feasibility study of PWID attending drug treatment or IEP in four UK regions. Ninety-nine PWID were randomly allocated to receive a three-session manualised psychosocial group intervention and BBV transmission information booklet plus treatment as usual (TAU) (n = 52) or information booklet plus TAU (n = 47). The intervention was developed from evidence-based literature, qualitative interviews with PWID, key stakeholder consultations, and expert opinion. Recruitment rates, retention in treatment, follow-up completion rates and health economic data completion measured feasibility.ResultsFifty-six percent (99/176) of eligible PWID were recruited. More participants attended at least one intervention session in London (10/16; 63%) and North Wales (7/13; 54%) than in Glasgow (3/12; 25%) and York (0/11). Participants who attended no sessions (n = 32) compared to those attending at least one (n = 20) session were more likely to be homeless (56 vs 25%, p = 0.044), injected drugs for a greater number of days (median 25 vs 6.5, p = 0.019) and used a greater number of needles from an IEP in the last month (median 31 vs 20, p = 0.056). No adverse events were reported. 45.5% (45/99) were followed up 1 month post-intervention. Feedback forms confirmed that the intervention was acceptable to both intervention facilitators and participants who attended it. Follow-up attendance was associated with fewer days of injecting in the last month (median 14 vs 27, p = 0.030) and fewer injections of cocaine (13 vs 30%, p = 0.063). Analysis of the questionnaires identified several service use questionnaire categories that could be excluded from the assessment battery in a full-randomised controlled trial.ConclusionsFindings should be interpreted with caution due to small sample sizes. A future definitive RCT of the psychosocial intervention is not feasible. The complex needs of some PWID may have limited their engagement in the intervention. More flexible delivery methods may have greater reach.
KW - Blood-borne virus transmission
KW - Feasibility randomised controlled trial
KW - Focus group research
KW - People who inject drugs
KW - Psychosocial interventions
U2 - 10.1186/s12954-017-0142-5
DO - 10.1186/s12954-017-0142-5
M3 - Article
C2 - 28320406
AN - SCOPUS:85015614451
SN - 1477-7517
VL - 14
SP - 1
EP - 15
JO - Harm Reduction Journal
JF - Harm Reduction Journal
M1 - 14
ER -