Now showing 1 - 2 of 2
  • Publication
    Psychosocial Interventions for Alcohol use among problem drug users (PINTA) : protocol for a feasibility study in primary care
    Background: Alcohol use is an important issue among problem drug users. Although screening and brief intervention are effective in reducing problem alcohol use in primary care, no research has examined this issue among problem drug users. Objectives: To determine if a complex intervention, incorporating screening and brief intervention for problem alcohol use among problem drug users, is feasible and acceptable in practice and effective in reducing the proportion of patients with problem alcohol use. Methods: PINTA is a pilot feasibility study of a complex intervention comprising screening and brief intervention for problem alcohol use among problem drug users with cluster randomisation at the level of general practice, integrated qualitative process evaluation, and involving general practices in two socioeconomically deprived regions. Participants: 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 inclusion criteria are: aged 18 or over and receiving addiction treatment / care (e.g.methadone) or known to be a problem drug user. Interventions: A complex intervention, supporting screening and brief intervention for problem alcohol use among problem drug users (experimental group) compared to an 'assessment only' control group. A delayed intervention being available to 'control' practices after follow up. Outcome: Primary outcomes are feasibility and acceptability of the intervention to patients andprofessionals. Secondary outcome is the effectiveness of the intervention on care process (documented rates of screening and brief intervention) and outcome (proportion of patients with problem alcohol use at the follow up). Randomisation: Stratified random sampling of general practices based on level of training in providing addiction-related care and geographical area. Blinding: Single-blinded; GPs and practice staff, researchers and trainers will not be blinded, but patients and remote randomisers will. Discussion: This is the first study to examine feasibility and acceptability of primary care based complex intervention to enhance alcohol screening and brief intervention among problem drug users. Results will inform future research among this high-risk population and guide policy and service development locally and internationally.
  • Publication
    Problem alcohol use among problem drug users : development of clinical guidelines for general practice
    Introduction: Problem alcohol use is common and associated with considerable adverse health and social outcomes among patients who attend GPs in Ireland and other European countries for opioid substitution treatment. This paper aims to describe the development and content of clinical guidelines for the management of problem alcohol use among current or former opioid users attending general practice for methadone treatment. Methods: The guidelines were developed in several stages: i) identification of key stakeholders; ii) development of evidence-based draft guidelines, and iii)determination of a modified ‘Delphi-facilitated’ consensus among the group members. These guidelines were informed by a review of scientific evidence and a qualitative study, results of which will be presented also at this conference. Results: The guidelines incorporate advice for GPs on all aspects of care of this problem, including i) definition of problem alcohol use among problem drug users, ii) screening / identification of problem alcohol use, iii) interventions for treatment and management of problem alcohol use, iv) referral to secondary services and v) role of GPs in the management of persistent problem alcohol use and on-going care. Conclusions: General practice has an important role to play in the care of problem alcohol use among problem drug users, especially patients who attend for methadone treatment. Further research on strategies to inform the implementation of this study is a priority.