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Randomized Controlled Trial
. 2016 Apr;133(4):298-309.
doi: 10.1111/acps.12530. Epub 2015 Nov 21.

Pilot randomised trial of a brief intervention for comorbid substance misuse in psychiatric in-patient settings

H L Graham  1 , A Copello  1 , E Griffith  2 , N Freemantle  3 , P McCrone  4 , L Clarke  1 , K Walsh  1 , C A Stefanidou  1 , A Rana  1 , M Birchwood  5
Affiliations
Randomized Controlled Trial

Pilot randomised trial of a brief intervention for comorbid substance misuse in psychiatric in-patient settings

H L Graham et al. Acta Psychiatr Scand. 2016 Apr.

Abstract

Objective: This proof of principle study evaluated the effectiveness and feasibility of a brief motivational intervention, delivered in mental health in-patient settings, to improve engagement in treatment for drug and alcohol misuse.

Method: A randomised controlled trial using concealed randomisation, blind, independent assessment of outcome at 3 months. Participants were 59 new adult admissions, to six acute mental health hospital units in one UK mental health service, with schizophrenia related or bipolar disorder diagnoses, users of community mental health services and also misusing alcohol and/or drugs. Participants were randomised to Brief Integrated Motivational Intervention (BIMI) with Treatment As Usual (TAU), or TAU alone. The BIMI took place over a 2-week period and encouraged participants to explore substance use and its impact on mental health.

Results: Fifty-nine in-patients (BIMI n = 30; TAU n = 29) were randomised, the BIMI was associated with a 63% relative odds increase in the primary outcome engagement in treatment [OR 1.63 (95% CI 1.01-2.65; P = 0.047)], at 3 months. Qualitative interviews with staff and participants indicated that the BIMI was both feasible and acceptable.

Conclusion: Mental health hospital admissions present an opportunity for brief motivational interventions focussed on substance misuse and can lead to improvements in engagement.

Keywords: dual diagnosis; hospital admission; randomised controlled trial; schizophrenia; substance misuse.

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Figures

Figure 1
Figure 1
CONSORT diagram of trial profile. 1Did not meet inclusion criteria: No substance misuse/Substance use not recorded (n = 872), Use substances but not other inclusion criteria (n = 1104) (Inclusion criteria not met due to either, mental health, care co‐ordinator unavailable/unallocated, rating unavailable, discharged prior to rating, language, mental health capacity, care being transferred to or from another service). 2Other: includes previously consented (n = 6), previously refused (n = 15), previously withdrawn (n = 1), discharged before rating (n = 30), unable to rate (n = 28), discharged before met (n = 32), not randomized – withdrawn (n = 4), not randomized – discharged (n = 2).
See this image and copyright information in PMC

References

    1. Lau K, Freyer‐Adam J, Gaertner B, Rumpf HJ, John U, Hapke U. Motivation to change risky drinking and motivation to seek help for alcohol risk drinking among general hospital inpatients with problem drinking and alcohol‐related diseases. Gen Hosp Psychiatry 2010;32:86–93. - PubMed
    1. Désy PM, Howard PK, Perhats C, Li S. Alcohol screening, brief intervention, and referral to treatment conducted by emergency nurses: an impact evaluation. J Emerg Nurs 2010;36:538–545. - PubMed
    1. Cobain K, Owens L, Kolamunnage‐Dona R, Fitzgerald R, Gilmore I, Pirmohamed M. Brief interventions in dependent drinkers: a comparative prospective analysis in two hospitals. Alcohol Alcohol 2011;46:434–440. - PubMed
    1. Rosenthal RN. An inpatient‐based service model In: Graham HL, Copello A, Birchwood MJ, Mueser KT, eds. Substance misuse in psychosis: approaches to treatment and service delivery. Chichester, UK: Wiley & Sons, 2003:136–155.
    1. Blow FC, Walton MA, Murray R et al. Intervention attendance among emergency department patients with alcohol and drug‐use disorders. J Stud Alcohol Drugs 2010;71:713–719. - PMC - PubMed

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