Brief Intervention for Prescription Drug Misuse in General Hospital
Condition: Substance-related Disorders
MeSH terms: Substance-Related Disorders
Study type: Interventional
Phase: Phase 2

Summary: 
      In a randomized controlled trial, patients recruited in a general hospital and fulfilling
      criteria for regular consumption (more than 60 days within the last three months), dependence
      or abuse of prescription drugs will be randomly allocated to two conditions:(1) Intervention
      group consisting of two counselling sessions based on Motivational Interviewing plus a
      personalized feedback, (2) Control group receiving a booklet on health behavior.

      Outcome assessment will be conducted after 12 months. The hypothesis is that counseling leads
      to greater reduction in consumption of prescription drugs (including discontinuation) and
      elevated readiness to change at follow-up.
    

Detailed description: 
      Background: Dependence on prescription drugs (DPD) is highly prevalent, whereby rate of
      substance specific treatment is low. A pilot study revealed elevated prevalence rates in
      general hospital patients compared to the general population and a positive attitude of
      patients suffering from DPD towards counseling. Brief intervention delivered in general
      hospital might be useful to promote discontinuation of prescription drug use and utilization
      of formal help.

      Objectives: To test the efficacy of a brief intervention based on Motivational Interviewing
      in proactively recruited general hospital patients randomly allocated to an intervention or a
      control group. Methods: Patients aged 18 to 69 years are proactively recruited in surgical
      and internal wards of two general hospitals in the northern German city of Lübeck. Patients
      with regular use of prescription drugs in the last three months and/or prescription drug
      dependence or -abuse are randomly assigned to two conditions: (1) an intervention group with
      two counseling sessions based on Motivational Interviewing plus one individualized feedback
      based on the Transtheoretical Model of behavior change (TTM) or (2) as usual care. Outcome
      measures are reduction or discontinuation of prescription drug use and utilization of formal
      help. The efficacy of the intervention will be examined within a 3 and a 12 month follow up.

      Expected impact: Findings are expected to provide evidence for brief interventions for
      prescription drug misuse to be used in primary care. This would be the first international
      results confirming such an approach in the field of prescription drug misuse. If a brief
      interventions would be effective, this could enhance secondary prevention for this under
      served population. Therefore, data are of great public health interest.
    

Intervention name(s): Motivational Interviewing
Intervention type(s): Behavioral
Intervention description(s): Two sessions of Motivational Interviewing (after baseline assessment and 4 weeks later) plus one individualized feedback based on the Transtheoretical Model of Behavior Change (8 weeks after baseline assessment)
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Prescription drug use disorder; Brief intervention; General hospital; Motivational Interviewing