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

Gail Gilchrist, Davina Swan, April Shaw, Ada Keding, Sarah Towers, Noel Craine, Alison Munro, Elizabeth Hughes, Steve Parrott, John Strang, Avril Taylor, Judith Watson

Research output: Contribution to journalArticle

Abstract

Background: While 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.
Methods: A pragmatic, two-armed randomised controlled, open feasibility study of PWID attending drug treatment or IEP in four UK regions. 99 PWID were randomly allocated to receive a 3-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.
Results: 56% (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) sessions 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 one 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.
Conclusions: Findings 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.
Trial registration: ISRCTN ISRCTN73824458. Registered 28 September 2014.
Original languageEnglish
Number of pages15
JournalHarm Reduction Journal
Volume14
Issue number14
DOIs
Publication statusPublished - 21 Mar 2017

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Risk-Taking
Viruses
Pharmaceutical Preparations
Equipment and Supplies
Pamphlets
Opiate Alkaloids
Wales
Expert Testimony
Feasibility Studies
Therapeutics
Blood Group Antigens
Cocaine
Sample Size
Needles
Referral and Consultation
Randomized Controlled Trials
Economics
Interviews
Injections
Health

Cite this

Gilchrist, Gail ; Swan, Davina ; Shaw, April ; Keding, Ada ; Towers, Sarah ; Craine, Noel ; Munro, Alison ; Hughes, Elizabeth ; Parrott, Steve ; Strang, John ; Taylor, Avril ; Watson, Judith. / 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. In: Harm Reduction Journal. 2017 ; Vol. 14, No. 14.
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abstract = "Background: While 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.Methods: A pragmatic, two-armed randomised controlled, open feasibility study of PWID attending drug treatment or IEP in four UK regions. 99 PWID were randomly allocated to receive a 3-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-basedliterature; 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.Results: 56{\%} (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) sessions 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 one 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.Conclusions: Findings 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.Trial registration: ISRCTN ISRCTN73824458. Registered 28 September 2014.",
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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. / Gilchrist, Gail; Swan, Davina; Shaw, April; Keding, Ada; Towers, Sarah; Craine, Noel; Munro, Alison; Hughes, Elizabeth; Parrott, Steve; Strang, John; Taylor, Avril; Watson, Judith.

In: Harm Reduction Journal, Vol. 14, No. 14, 21.03.2017.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The acceptability and feasibility of a brief psychosocial intervention to reduce blood-borne virus risk behaviours among people who inject drugs

T2 - 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

PY - 2017/3/21

Y1 - 2017/3/21

N2 - Background: While 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.Methods: A pragmatic, two-armed randomised controlled, open feasibility study of PWID attending drug treatment or IEP in four UK regions. 99 PWID were randomly allocated to receive a 3-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-basedliterature; 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.Results: 56% (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) sessions 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 one 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.Conclusions: Findings 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.Trial registration: ISRCTN ISRCTN73824458. Registered 28 September 2014.

AB - Background: While 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.Methods: A pragmatic, two-armed randomised controlled, open feasibility study of PWID attending drug treatment or IEP in four UK regions. 99 PWID were randomly allocated to receive a 3-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-basedliterature; 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.Results: 56% (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) sessions 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 one 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.Conclusions: Findings 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.Trial registration: ISRCTN ISRCTN73824458. Registered 28 September 2014.

KW - Blood-borne virus transmission

KW - People who inject drugs

KW - Feasibility randomised controlled trial

KW - Psychosocial interventions

KW - Focus group research

U2 - 10.1186/s12954-017-0142-5

DO - 10.1186/s12954-017-0142-5

M3 - Article

VL - 14

JO - Harm Reduction Journal

JF - Harm Reduction Journal

SN - 1477-7517

IS - 14

ER -