Telephone delivered incentives for encouraging adherence to supervised methadone consumption (TIES): Study protocol for a feasibility study for an RCT of clinical and cost effectiveness

Nicola Metrebian; Timothy Weaver; Stephen Pilling; Kimberley Goldsmith; Ewan Carr; James Shearer; Kathryn Woolston-Thomas; Basak Tas; Carol-Ann Getty; Charlotte Cooper; Rob van der Waal; Michael Kelleher; Emily Finch; Prun Bijral; David Taylor; Jenny Scott; John Strang

Contemporary Clinical Trials Communications (Mar 2020)

Telephone delivered incentives for encouraging adherence to supervised methadone consumption (TIES): Study protocol for a feasibility study for an RCT of clinical and cost effectiveness

Nicola Metrebian,
Timothy Weaver,
Stephen Pilling,
Kimberley Goldsmith,
Ewan Carr,
James Shearer,
Kathryn Woolston-Thomas,
Basak Tas,
Carol-Ann Getty,
Charlotte Cooper,
Rob van der Waal,
Michael Kelleher,
Emily Finch,
Prun Bijral,
David Taylor,
Jenny Scott,
John Strang

Affiliations

Nicola Metrebian: King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, Camberwell, London, SE5 8AB, UK; Corresponding author. Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 4 Windsor Walk, Denmark Hill, London, SE5 8BB, UK.
Timothy Weaver: Middlesex University, Department of Mental Health, Social Work and Integrative Medicine, School of Health and Education, The Burroughs, London, NW4 4BT, UK
Stephen Pilling: University College London, National Collaborating Centre for Mental Health, Research Department of Clinical, Educational and Health Psychology, University College London 1-19 Torrington Place London, WC1 7HB, UK
Kimberley Goldsmith: King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, Camberwell, London, SE5 8AB, UK
Ewan Carr: King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, Camberwell, London, SE5 8AB, UK
James Shearer: King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, Camberwell, London, SE5 8AB, UK
Kathryn Woolston-Thomas: King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, Camberwell, London, SE5 8AB, UK
Basak Tas: King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, Camberwell, London, SE5 8AB, UK
Carol-Ann Getty: King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, Camberwell, London, SE5 8AB, UK
Charlotte Cooper: King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, Camberwell, London, SE5 8AB, UK
Rob van der Waal: South London and Maudsley NHS Foundation Trust, Southwark, Central Acute and Addictions Directorate, Marina House, 63-65 Denmark Hill, London, SE5 8RS, UK
Michael Kelleher: South London and Maudsley NHS Foundation Trust, Southwark, Central Acute and Addictions Directorate, Marina House, 63-65 Denmark Hill, London, SE5 8RS, UK
Emily Finch: South London and Maudsley NHS Foundation Trust, Southwark, Central Acute and Addictions Directorate, Marina House, 63-65 Denmark Hill, London, SE5 8RS, UK
Prun Bijral: Change, Grow, Live, 39-41 Thomas Street, Manchester, M4 1NA, UK
David Taylor: King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, Camberwell, London, SE5 8AB, UK; South London and Maudsley NHS Foundation Trust, Southwark, Central Acute and Addictions Directorate, Marina House, 63-65 Denmark Hill, London, SE5 8RS, UK
Jenny Scott: University of Bath, Claverton Down, Bath, BA2 7AY, UK
John Strang: King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, Camberwell, London, SE5 8AB, UK; South London and Maudsley NHS Foundation Trust, Southwark, Central Acute and Addictions Directorate, Marina House, 63-65 Denmark Hill, London, SE5 8RS, UK

Journal volume & issue: Vol. 17

Abstract

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The majority of people receiving treatment for their heroin addiction, are prescribed methadone; for which there is an extensive evidence base. When treatment starts, people take their daily dose of methadone under supervision at a community pharmacy. Supervision guarantees methadone is taken as directed by the individual for whom it has been prescribed, helps to ensure individuals take their correct dose every day, and safeguards against diversion and overdose. However, individuals often fail to attend the pharmacy to take their methadone. Each missed dose is of concern. If a patient misses their daily dose of methadone, they will start to experience opiate withdrawal and cravings and are more likely to use heroin. If they miss three days dose, there are concerns that they may lose tolerance to the drug and may be at risk of overdose when the next dose is taken. Hence there is an urgent need to develop effective interventions for medication adherence. Research suggests that incentive-based medication adherence interventions may be very effective, but there are few controlled trials and the provision of incentives requires time and organisational systems which can be challenging in pharmacies. The investigators have developed the technology to deliver incentives by mobile telephone. This cluster randomised trial will test the feasibility of conducting a future trial evaluating the clinical and cost effectiveness of using telephone delivered incentives (praise and modest financial rewards via text messaging) to encourage adherence with supervised consumption of methadone in community pharmacies. Three drug services (each with two or three community pharmacies supervising methadone consumption that will enrol 20 individuals, a total of 60 participants) will be recruited and randomly allocated to deliver either i) telephone delivered incentives, ii) telephone delivered reminders or iii) no telephone system. Acceptability, recruitment, follow-up, and suitable measures of clinical and cost effectiveness will be assessed. Findings from this feasibility study will be assessed against stated progression criteria and used to inform a future confirmatory trial of the clinical and cost effectiveness of telephone delivered incentives to encourage medication adherence. Trial registration: ISRCTN58958179 (retrospectively registered). Keywords: Opiate substitution treatment, Methadone, Supervised consumption, Pharmacies, Contingency management, Medication adherence, Financial incentives, Behavioural reinforcement, Heroin use

Published in Contemporary Clinical Trials Communications

ISSN: 2451-8654 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General)
Website: https://www.journals.elsevier.com/contemporary-clinical-trials-communications/

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