Opioid substitution treatment (OST) reduces the harm of
injecting and opioid dependence. The SCID feasibility trial explored the
processes of conducting a randomized control trial (RCT) with people who inject
drugs (PWID) in a low-threshold agency. Feasibility of the intervention
investigated whether offering PWID immediate access to OST via specialist
primary care increased numbers in OST at 3 months, compared with offering
advice and case management.
Un-blinded RCT was conducted at Bristol Drugs Project needle
exchange. A total of 311 individuals were eligible and 100 consented to
participate. Trial process outcomes involved exploring OST status at 3 months;
secondary outcomes were substance use and health-related quality of life
measures.
Follow-up was 86%. At 3 months, 51% intervention and 47% of
control participants were in OST (OR of success of intervention 1.17
(0.54-2.57)). Opioid use reduced by 79 and 73%, respectively (OR of intervention
success 1.38 (0.5-3.7)). Physical and mental health improved but there was
little differences between groups.
The feasibility of conducting the trial was a success, but
there was insufficient evidence of an effect compared with intensive case
management. Further development and evaluation of case management approaches in
low-threshold agencies is warranted.
Purchase full article at: http://goo.gl/CKZhp6
By:
- 1School of Social and Community Medicine, University of Bristol, Bristol, UK.
- 2Lawrence Hill Health Centre, Bristol, UK.
- 3NIHR Research Design Service-South West, University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
- 4Bristol Drugs Project, Bristol, UK.
- 5Bristol City Council, Bristol, UK.
- 6School of Social and Community Medicine, University of Bristol, Bristol, UK Bristol City Council, Bristol, UK.
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