2.50
Hdl Handle:
http://hdl.handle.net/10755/157311
Type:
Presentation
Title:
REDUCTION OF DRUG USE AMONG METHADONE MAINTAINED CLIENTS
Abstract:
REDUCTION OF DRUG USE AMONG METHADONE MAINTAINED CLIENTS
Conference Sponsor:Western Institute of Nursing
Conference Year:2010
Author:Nyamathi, Adeline, ANP, PhD, FAAN
P.I. Institution Name:University of California, Los Angeles
Title:Professor & Audrienne H. Moseley Endowed Chair in Community Health Research; Acting Assoc Dean for Research & Director of T32
Contact Address:2-250 Factor Bldg, Box 951702, Los Angeles, CA, 90095-1702, USA
PURPOSES/AIMS:
To evaluate the impact of a Nurse-led hepatitis health promotion program (HHP) compared with Motivational Interviewing (MI), delivered by trained therapists in group sessions or one-on-one, on reduction of drug use among methadone maintained clients.
RATIONALE/CONCEPTUAL BASIS/BACKGROUND:
Methadone-Maintained (MM) clients have reported ongoing opioid use; in fact, nearly 50% of this population has reported chronic drug use. Injection drug using (IDU) clients in particular are at high risk for HIV, HBV and HCV infections. MI may be one strategy to decrease drug use in this population. To date, however, no studies have compared MI intervention to Nurse-led HHP among MM clients.
METHODS:
A three-arm randomized, controlled trial was conducted with 256 MM adults attending one of five MM outpatient clinics in the Los Angeles area. Within each site, moderate-to-heavy alcohol-using MM participants were randomized into one of three conditions: 1) MI delivered in group session (MI-group; n=79), MI delivered one-on-one (MI-single, n=90), and 3) Nurse-led HHP (n=87). Participants in either MI program were offered three, 60-minute sessions that were delivered (one-on-one or via group format) by trained MI specialists. The MI sessions were focused on the impact of substance use on health, risky behaviors and subsequent life goals. The HHP sessions focused on hepatitis education; specifically, the progression of HCV infection and the behaviors that infected individuals can adopt to prevent or reduce accumulated damage to liver functioning. For both MI and HHP programs, the three-series HAV/HBV vaccine was administered by the research nurse, if the participant was eligible for the vaccine. The Comprehensive Health Seeking and Coping Paradigm served as the theoretical guide for the study. Culturally sensitive instruments were administered by the research staff. A composite drug score was determined by taking a weighted sum of the drug route and the frequency for each of the various drugs taken. Two of these composite scores were created, one to measure the 6 month recall and the other, a 30 day recall.
RESULTS:
More than half the sample (59%) was male and predominantly African American (45%) or Latino (27%). The mean age of the sample was 51 years (SD: 8.4). A total of 86.7% of participants completed all three sessions and 91.3% completed the six month follow-up. Almost half of MM participants disclosed IDU during the past six months prior to enrollment. While no differences were apparent in intervention type, drug use behavior was significantly reduced from baseline to six month follow-up. Multivariate analysis revealed that having support from non-drug users was associated with improvement in drug use in the past 30 days (p = 0.05). At six-month follow-up, recruitment site, no lifetime sex trade, and no IDU at baseline were all associated with improvement in drug use (p = 0.001, p=0.05, p=0.03, respectively).
IMPLICATIONS:
As compared to two programs delivered by MI specialists, a culturally-sensitive and easy to implement Nurse-led HHP produced similar reductions in drug use over six months. Cost effectiveness investigations to assess differences across programs using a larger sample base will be critical.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleREDUCTION OF DRUG USE AMONG METHADONE MAINTAINED CLIENTSen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157311-
dc.description.abstract<table><tr><td colspan="2" class="item-title">REDUCTION OF DRUG USE AMONG METHADONE MAINTAINED CLIENTS</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Nyamathi, Adeline, ANP, PhD, FAAN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of California, Los Angeles</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Professor &amp; Audrienne H. Moseley Endowed Chair in Community Health Research; Acting Assoc Dean for Research &amp; Director of T32</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">2-250 Factor Bldg, Box 951702, Los Angeles, CA, 90095-1702, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">anyamath@sonnet.ucla.edu</td></tr><tr><td colspan="2" class="item-abstract">PURPOSES/AIMS: <br/>To evaluate the impact of a Nurse-led hepatitis health promotion program (HHP) compared with Motivational Interviewing (MI), delivered by trained therapists in group sessions or one-on-one, on reduction of drug use among methadone maintained clients. <br/>RATIONALE/CONCEPTUAL BASIS/BACKGROUND: <br/>Methadone-Maintained (MM) clients have reported ongoing opioid use; in fact, nearly 50% of this population has reported chronic drug use. Injection drug using (IDU) clients in particular are at high risk for HIV, HBV and HCV infections. MI may be one strategy to decrease drug use in this population. To date, however, no studies have compared MI intervention to Nurse-led HHP among MM clients. <br/>METHODS: <br/>A three-arm randomized, controlled trial was conducted with 256 MM adults attending one of five MM outpatient clinics in the Los Angeles area. Within each site, moderate-to-heavy alcohol-using MM participants were randomized into one of three conditions: 1) MI delivered in group session (MI-group; n=79), MI delivered one-on-one (MI-single, n=90), and 3) Nurse-led HHP (n=87). Participants in either MI program were offered three, 60-minute sessions that were delivered (one-on-one or via group format) by trained MI specialists. The MI sessions were focused on the impact of substance use on health, risky behaviors and subsequent life goals. The HHP sessions focused on hepatitis education; specifically, the progression of HCV infection and the behaviors that infected individuals can adopt to prevent or reduce accumulated damage to liver functioning. For both MI and HHP programs, the three-series HAV/HBV vaccine was administered by the research nurse, if the participant was eligible for the vaccine. The Comprehensive Health Seeking and Coping Paradigm served as the theoretical guide for the study. Culturally sensitive instruments were administered by the research staff. A composite drug score was determined by taking a weighted sum of the drug route and the frequency for each of the various drugs taken. Two of these composite scores were created, one to measure the 6 month recall and the other, a 30 day recall. <br/>RESULTS: <br/>More than half the sample (59%) was male and predominantly African American (45%) or Latino (27%). The mean age of the sample was 51 years (SD: 8.4). A total of 86.7% of participants completed all three sessions and 91.3% completed the six month follow-up. Almost half of MM participants disclosed IDU during the past six months prior to enrollment. While no differences were apparent in intervention type, drug use behavior was significantly reduced from baseline to six month follow-up. Multivariate analysis revealed that having support from non-drug users was associated with improvement in drug use in the past 30 days (p = 0.05). At six-month follow-up, recruitment site, no lifetime sex trade, and no IDU at baseline were all associated with improvement in drug use (p = 0.001, p=0.05, p=0.03, respectively). <br/>IMPLICATIONS: <br/>As compared to two programs delivered by MI specialists, a culturally-sensitive and easy to implement Nurse-led HHP produced similar reductions in drug use over six months. Cost effectiveness investigations to assess differences across programs using a larger sample base will be critical.<br/></td></tr></table>en_GB
dc.date.available2011-10-26T19:45:28Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T19:45:28Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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