A pilot study to assess the feasibility and impact of a brief motivational intervention on problem drug and alcohol use in adult mental health inpatient units: study protocol for a randomized controlled trialReportar como inadecuado




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Trials

, 15:308

First Online: 01 August 2014Received: 16 May 2014Accepted: 14 July 2014DOI: 10.1186-1745-6215-15-308

Cite this article as: Graham, H.L., Birchwood, M., Griffith, E. et al. Trials 2014 15: 308. doi:10.1186-1745-6215-15-308

Abstract

BackgroundSubstance misuse in those with severe mental health problems is common and associated with poor engagement in treatment and treatment outcomes. Up to 44% of those admitted into psychiatric inpatient facilities have coexisting substance-misuse problems. However, this is not routinely addressed as part of their treatment plan. A mental health admission may present a window of opportunity for inpatients to reevaluate the impact of their substance use. This study will aim to evaluate the effectiveness of a targeted brief motivational intervention in improving engagement in treatment and to assess how feasible and acceptable this intervention is to inpatients and staff as a routine intervention.

Methods-DesignThis randomized controlled trial will use concealed randomization; blind, independent assessment of outcome at 3 months; characterization of refusers and dropouts; and be analyzed according to the intention-to-treat principle. After baseline assessments, eligible participants will be randomized either to the Brief Integrated Motivational Intervention plus Treatment As Usual, or Treatment as Usual alone. Eligible participants will be those who are new admissions; >18 years; ICD-10 diagnosis of -schizophrenia or related disorder, bipolar affective disorder, recurrent depressive disorder, and DSM-IV diagnosis of substance abuse or dependence over the last 3 months. The primary outcome is engagement in treatment for substance misuse, and secondary outcomes include readiness to change substance misuse together with a cost-effectiveness analysis. Qualitative interviews with staff and participants will assess the acceptability of the intervention.

DiscussionThis pilot randomized trial will provide the first robust evidence base for inpatient care of people with severe mental health problems and co-morbid substance misuse and provide the groundwork for confirmatory trials to evaluate a potentially feasible, cost-effective, and easy-to-implement treatment option that may be readily integrated into standard inpatient and community-based care.

Trial registrationISRCTN43548483 Date of ISRCTN assignation: 4-17-2014.

KeywordsInpatient Comorbid intervention Brief motivational intervention Treatment Randomized controlled trial Dual diagnosis Substance misuse Severe mental health condition Schizophrenia Psychiatric hospital admission AbbreviationsICD-10International Classification of Disorders, 10th Edition

DSM-IVDiagnostic and Statistical Manual of Mental Disorders, Fourth Edition

UKUnited Kingdom

MIBrief Integrated Motivational Intervention

TAUtreatment as usual

PICUPsychiatric Intensive Care Unit

COMPASS Programme teamCombined Psychosis and Substance Misuse, a specialist -dual diagnosis- Trust-wide service

CSOClinical Studies Officer

SATSSubstance Abuse Treatment Scale

SOCRATESStages Of Change Readiness And Treatment Eagerness Scale

CDUS-CAUSThe Clinicians Alcohol-Drugs Use rating scales

MAPMaudsley Addiction Profile

AUDITThe Alcohol Use Disorders Identification Test

RSQRecovery Style Questionnaire

HADSHospital Anxiety and Depression Scale

ISThe Insight Scale

EQ-5DEuroQol – 5 Dimensions

QALYsQuality-adjusted life-year.

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Autor: Hermine L Graham - Max Birchwood - Emma Griffith - Nick Freemantle - Paul McCrone - Chrysi A Stefanidou - Kathryn Walsh -

Fuente: https://link.springer.com/







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