Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Psychiatry
Published in: BMC Psychiatry 1/2016

Open Access 01-12-2016 | Research article

Tailoring a brief intervention for illicit drug use and alcohol use in Irish methadone maintained opiate dependent patients: a qualitative process

Authors: Catherine Darker, Brion Sweeney, Eamon Keenan, Lucy Whiston, Rolande Anderson, Joe Barry

Published in: BMC Psychiatry | Issue 1/2016

Login to get access

Abstract

Background

The World Health Organization (WHO) recommend the tailoring of a brief intervention (BI) programme of research to ensure that it is both culturally and contextually appropriate for the country and the environment in which it is being tested. The majority of BI research has been conducted with non-opioid dependent participants. The current study developed a tailored BI for illicit drug use and alcohol use to a methadone maintained opioid dependent polydrug using cohort of patients.

Methods

Focus groups with staff and one-to-one qualitative interviews with patients guided the tailoring of all intervention materials for use in a subsequent cluster randomised controlled trial (RCT). This was done to make them contextually appropriate to an opioid dependent cohort and culturally appropriate to Ireland. Thematic analyses were utilised.

Results

The BI was modified to ensure its compatibility with the culture of an Irish drug using population, with elements of motivational interviewing (MI) and personalised feedback incorporated. Example scripts of a screening and BI were included, as was an algorithm to facilitate clinicians during a session. Modifications to the ‘Substance Use Risk’ cards included weighting the severity of the problems, writing the language in the first person to personalise the feedback and including tick boxes so as to further highlight the relevant risk factors for individual patients. Photographs of key risk factors were included to display pictorially risks for illiterate or semi-literate patients. Examples of the interaction of particular substances with methadone were of particular importance to this group. Modifications of the ‘Pros and Cons of Substance Use/Reasons to Quit or Cut Down’ included additional categories such as addiction, crime and money that were salient to this cohort. The manual was used to standardise training across trial sites.

Conclusion

The research team was faithful to WHO recommendations to tailor BI programmes that are culturally and contextually appropriate to the treatment cohort and clinical environment. Outcome data from the cluster RCT have demonstrated that the tailored intervention was effective.
Appendix
Available only for authorised users
Literature
1.
Humeniuk R, Henry-Edwards S, Ali R, Poznyak V, Monteiro M. The ASSIST-linked brief intervention for hazardouse and harmful substance use: manual for use in primary care. Geneva: World Health Organization; 2010.
2.
Humeniuk R, Ali R, Babor T, Souza-Formigoni MLO, De Lacerda RB, Ling W, et al. A randomized controlled trial of a brief intervention for illicit drugs linked to the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in clients recruited from primary health-care settings in four countries. Addict Abingdon Engl. 2012;107:957–66.CrossRef
3.
WHO ASSIST Working Group. The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): development, reliability and feasibility. Addict Abingdon Engl. 2002;97:1183–94.CrossRef
4.
Babor TF, McRee BG, Kassebaum PA, Grimaldi PL, Ahmed K, Bray J. Screening, Brief Intervention, and Referral to Treatment (SBIRT): toward a public health approach to the management of substance abuse. Subst Abuse Off Publ Assoc Med Educ Res Subst Abuse. 2007;28:7–30.
5.
Prochaska J, DiClemente C. Transtheorectial therapy: toward a more integrative model of change. Psychother Theory Res Pract. 1982;19:276–88.CrossRef
6.
Miller W, Rollnick S. Motivational interviewing: Preparing people for change 2nd ed. 2nd ed. New York: The Guilford Press; 2002.
7.
BIEN TH, MILLER WR, TONIGAN JS. Brief interventions for alcohol problems: a review. Addiction. 1993;88:315–36.CrossRefPubMed
8.
Kaner E, Dickinson H, Beyer F, Campbell F, Schlesinger C, Heather N, et al. Effectiveness of brief alcohol interventions in primary care populations. Cochrane Database Syst Rev Online. 2007;18(2):CD004148.
9.
WHO Brief Intervention Study Group. A cross-national trial of brief interventions with heavy drinkers. Am J Public Health. 1996;86:948–55.CrossRef
10.
Wilk AI, Jensen NM, Havighurst TC. Meta-analysis of Randomized Control Trials Addressing Brief Interventions in Heavy Alcohol Drinkers. J Gen Intern Med. 1997;12:274–83.CrossRefPubMedPubMedCentral
11.
Humeniuk R, Dennington V, Ali R. The effectiveness of a brief intervention for illicit drugs linked to the alcohol, smoking and substance involvement screening test (ASSIST) in primary health care settings: A technical report of phase III findings of the WHO ASSIST randomized controlled trial. In: World Health Organization. Department of Mental Health and Substance Dependence. 2008.
12.
Baker A, Boggs TG, Lewin TJ. Randomized controlled trial of brief cognitive-behavioural interventions among regular users of amphetamine. Addict Abingdon Engl. 2001;96:1279–87.CrossRef
13.
Bashir K, King M, Ashworth M. Controlled evaluation of brief intervention by general practitioners to reduce chronic use of benzodiazepines. Br J Gen Pr. 1994;44:408–12.
14.
Babor TF. Brief Treatments for Cannabis Dependence: Findings From a Randomized Multisite Trial. J Consult Clin Psychol. 2004;72:455–66.CrossRef
15.
Copeland J, Swift W, Roffman R, Stephens R. A randomized controlled trial of brief cognitive-behavioral interventions for cannabis use disorder. J Subst Abuse Treat. 2001;21(55):64–6.
16.
Lang E, Engelander M, Brooke T. Report of an integrated brief intervention with self-defined problem cannabis users. J Subst Abuse Treat. 2000;19:111–6.CrossRefPubMed
17.
Bernstein J, Bernstein E, Tassiopoulos K, Heeren T, Levenson S, Hingson R. Brief motivational intervention at a clinic visit reduces cocaine and heroin use. Drug Alcohol Depend. 2005;77:49–59.CrossRefPubMed
18.
Stotts AL, Schmitz JM, Rhoades HM, Grabowski J. Motivational interviewing with cocaine-dependent patients: a pilot study. J Consult Clin Psychol. 2001;69:858–62.CrossRefPubMed
19.
Sorsdahl K, Stein DJ, Weich L, Fourie D, Myers B. The effectiveness of a hospital-based intervention for patients with substance-use problems in the Western Cape. South Afr Med J Suid-Afr Tydskr Vir Geneeskd. 2012;102:634–5.
20.
Darker CD, Sweeney BP, El Hassan HO, Smyth BP, Ivers J-HH, Barry JM. Brief interventions are effective in reducing alcohol consumption in opiate-dependent methadone-maintained patients: Results from an implementation study. Drug Alcohol Rev. [Internet]. 2011 [cited 2012 Feb 8]; Available from: http://​www.​ncbi.​nlm.​nih.​gov/​pubmed/​21919978
21.
Darker CD, Sweeney B, Keenan E, Whiston L, Anderson R, Barry J. Screening and Brief Interventions for Illicit Drug Use and Alcohol Use in Methadone Maintained Opiate-Dependent Patients: Results of a Pilot Cluster Randomized Controlled Trial Feasibility Study. Subst Use Misuse. 2016;51:1104–15.CrossRefPubMed
22.
Aarons GA, Hurlburt M, Horwitz SM. Advancing a conceptual model of evidence-based practice implementation in public service sectors. Adm Policy Ment Health. 2011;38:4–23.CrossRefPubMed
23.
Meyers DC, Durlak JA, Wandersman A. The quality implementation framework: a synthesis of critical steps in the implementation process. Am J Community Psychol. 2012;50:462–80.CrossRefPubMed
24.
Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci IS. 2009;4:50.CrossRefPubMed
25.
Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M. Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ. 2008;337:a1655.CrossRefPubMedPubMedCentral
26.
O’Cathain A, Thomas KJ, Drabble SJ, Rudolph A, Hewison J. What can qualitative research do for randomised controlled trials? A systematic mapping review. BMJ Open. 2013;3:e002889.CrossRefPubMedPubMedCentral
27.
Bradley F, Wiles R, Kinmonth A-L, Mant D, Gantley M. Development and evaluation of complex interventions in health services research: case study of the Southampton heart integrated care project (SHIP). BMJ. 1999;318:711–5.CrossRefPubMedPubMedCentral
28.
Corrrigan M, Cupples ME, Smith SM, Byrne M, Leathem CS, Clerkin P, et al. The contribution of qualitative research in designing a complex intervention for secondary prevention of coronary heart disease in two different healthcare systems. BMC Health Serv Res. 2006;6:90.CrossRefPubMedPubMedCentral
29.
Hoddinott P, Morgan H, Thomson G, Crossland N, Craig L, Britten J, et al. Intervention vignettes as a qualitative tool to refine complex intervention design. Trials. 2013;14:O55.CrossRefPubMedCentral
30.
Neff JA, Walters ST, Braitman AL, Kelley ML, Paulson JF, Brickhouse TH, et al. A brief motivational intervention for heavy alcohol use in dental practice settings: rationale and development. J Health Psychol. 2013;18:542–53.CrossRefPubMed
31.
Phillips KT, Altman JK, Corsi KF, Stein MD. Development of a risk reduction intervention to reduce bacterial and viral infections for injection drug users. Subst Use Misuse. 2013;48:54–64.CrossRefPubMed
32.
Aakhus E, Granlund I, Oxman AD, Flottorp SA. Tailoring interventions to implement recommendations for the treatment of elderly patients with depression: a qualitative study. Int J Ment Health Syst. 2015;9:36.CrossRefPubMedPubMedCentral
33.
Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care J Int Soc Qual Health Care ISQua. 2007;19:349–57.CrossRef
34.
35.
Wilkinson S, Joffe H, Yardley L. Qualitative data collection: interviews and focus groups. Res. Methods Clin. Health Psychol. London: Sage; 2004. p. 39–55.
36.
37.
Neuman WL, Neuman WL. Social research methods: Qualitative and quantitative approaches. 2006.
38.
Denzin NK, Lincoln YS. The discipline and practice of qualitative research. Handb Qual Res. 2000;2:1–28.
39.
40.
Vaismoradi M, Turunen H, Bondas T. Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study. Nurs Health Sci. 2013;15:398–405.CrossRefPubMed
41.
Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101.CrossRef
42.
DeSantis L, Ugarriza DN. The Concept of Theme as Used in Qualitative Nursing Research. West J Nurs Res. 2000;22:351–72.CrossRefPubMed
43.
44.
Bellg AJ, Borrelli B, Resnick B, Hecht J, Minicucci DS, Ory M, et al. Enhancing treatment fidelity in health behavior change studies: best practices and recommendations from the NIH Behavior Change Consortium. Health Psychol Off J Div Health Psychol Am Psychol Assoc. 2004;23:443–51.
45.
Oliver K, Innvar S, Lorenc T, Woodman J, Thomas J. A systematic review of barriers to and facilitators of the use of evidence by policymakers. BMC Health Serv Res. 2014;14:2.CrossRefPubMedPubMedCentral
46.
Darker C, Sweeney Brion P, Keenan E, Whiston L, Andersen R, Barry Joe M. Screening and brief interventions for illicit drug use and alcohol use in methadone maintained opiate dependent patients: results from a cluster randomised controlled trial. Subst. Use Misuse. 2016;52(9):1104–15.
47.
Metadata
Title
Tailoring a brief intervention for illicit drug use and alcohol use in Irish methadone maintained opiate dependent patients: a qualitative process
Authors
Catherine Darker
Brion Sweeney
Eamon Keenan
Lucy Whiston
Rolande Anderson
Joe Barry
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2016
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-016-1082-4

Other articles of this Issue 1/2016

BMC Psychiatry 1/2016 Go to the issue

Research article

Self-control and problematic mobile phone use in Chinese college students: the mediating role of mobile phone use patterns

Research article

Non-fatal disease burden for subtypes of depressive disorder: population-based epidemiological study

Research article

Accuracy of reported service use in a cohort of people who are chronically homeless and seriously mentally ill

Research article

Clinical outcomes and costs for people with complex psychosis; a naturalistic prospective cohort study of mental health rehabilitation service users in England

Research article

Occipital event-related potentials to addiction-related stimuli in detoxified patients with alcohol dependence, and their association with three-month relapse

Research article

A naturalistic study of high-dose unilateral ECT among severely depressed inpatients: how does it work in the clinical practice?