Open AccessDoes training in motivational interviewing for community pharmacists improve outcomes for methadone patients? A cluster randomised controlled trial
Author(s) -
Jaffray Mariesha,
Matheson Catriona,
Bond Christine M.,
Lee Amanda J.,
McLer David J.,
Johnstone Allan,
Skea Lucy,
Davidson Bruce
Publication year - 2014
Publication title -
international journal of pharmacy practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.42
H-Index - 37
eISSN - 2042-7174
pISSN - 0961-7671
DOI - 10.1111/ijpp.12049
Subject(s) - medicine , motivational interviewing , methadone , pharmacy , randomized controlled trial , intervention (counseling) , pharmacist , physical therapy , family medicine , nursing , psychiatry
Objectives Feasibility of pharmacist delivered motivational interviewing ( MI ) to methadone patients has been demonstrated, but its efficacy is untested. This study aimed to determine whether pharmacists trained in MI techniques can improve methadone outcomes. Methods A cluster randomised controlled trial by pharmacy, with community pharmacies across Scotland providing supervised methadone to >10 daily patients, aged >18 years, started on methadone <24 months. Pharmacies were randomised to intervention or control. Intervention pharmacists received MI training and a resource pack. Control pharmacists continued with normal practice. Primary outcome was illicit heroin use. Secondary outcomes were treatment retention, substance use, injecting behaviour, psychological/physical health, treatment satisfaction and patient feedback. Data were collected via structured interviews at baseline and 6 months. Key findings Seventy‐six pharmacies recruited 542 patients (295 intervention, 247 control), mean age 32 years; 64% male; 91% unemployed; mean treatment length 9 months. No significant difference in outcomes between groups for illicit heroin use (32.4% cf. 31.4%), although within‐groups use reduced ( P < 0.001); treatment retention was higher in the intervention group but not significantly (88% cf. 81%; P = 0.34); no significant difference between groups in treatment satisfaction, although this improved significantly in intervention ( P < 0.05). More intervention than control patients said pharmacists had ‘spoken more,’ which approached statistical significance ( P = 0.06), and more intervention patients found this useful ( P < 0.05). Conclusions Limited intervention delivery may have reduced study power. The intervention did not significantly reduce heroin use, but there are indications of positive benefits from increased communication and treatment satisfaction.