PHOENIx for people facing severe and multiple disadvantage
Research type
Research Study
Full title
Reducing disparities in health, economic and social outcomes for people facing severe and multiple disadvantage in Scotland: a definitive multicentre randomised controlled trial with parallel process and economic evaluation (PHOENIx)
IRAS ID
345246
Contact name
Richard Lowrie
Contact email
Sponsor organisation
University of Edinburgh
Duration of Study in the UK
2 years, 6 months, 31 days
Research summary
In Scotland, about 5,700 people experience three severe disadvantages at the same time: homelessness; substance misuse; and criminal justice system involvement. Most people facing these Severe and Multiple Disadvantages (PSMD) have poor health outcomes.
Third sector charity workers are trusted by, and accessible to PSMD. They offer help with accommodation, and vocational opportunities. However, many treatable opportunities are missed because healthcare professionals rarely go with them. If NHS clinicians were to join workers from charitable homeless organisations (many of whom have experienced SMD), the combination could address many of the multiple health and social care problems experienced by PSMD. Such a collaboration (PHOENIx: Pharmacist Outreach Engagement Non-medical Independent prescribing Rx) could treat PSMD holistically on outreach. They could treat physical and mental health conditions, and problems relating to substance use. They could address welfare benefits, housing and encourage recovery back into mainstream community life.
Identifying a solution that promotes economic and social prosperity for PSMD, our study will be set in Lothian, Grampian, Ayrshire, Highland and Tayside. We will randomly assign (like tossing a coin) 378 participants to either:
(1) Usual care;
or
(2) PHOENIx in addition to usual care.
PHOENIx participants will receive additional weekly visits from NHS prescriber clinicians and third sector workers, for nine months.
We will find out whether PHOENIx reduces the risk of fatal and non-fatal overdose, improves health, and community connectedness. We will also find out whether it reduces Accident and Emergency visits, hospitalisations, criminal justice system involvement. We will also gauge whether it is value for money. If the study results are positive, we will use them as a lever to improve the way we care for PSMD across the UK.REC name
North of Scotland Research Ethics Committee 2
REC reference
24/NS/0118
Date of REC Opinion
15 Oct 2024
REC opinion
Favourable Opinion