Realistic evaluation of CPHBs in injectable opioid treatment
Research type
Research Study
Full title
EVALUATION OF A NEW HYBRID CONTINGENCY MANAGEMENT PERSONAL HEALTH BUDGET INTERVENTION FOR INJECTABLE OPIOID TREATMENT
IRAS ID
155322
Contact name
Joanne Neale
Contact email
Sponsor organisation
King's College London
Research summary
There is good international evidence that supervised injectable opioid treatment (IOT) can reduce illicit drug use and improve the general health and wellbeing of patients who have very severe and chronic opioid dependence. Despite this, IOT is expensive and there is no clear ‘exit strategy’, with many patients remaining on injectable drugs long-term. In 2014/15, the London IOT clinic based within South London and Maudsley (SLaM) NHS Foundation Trust will pilot a novel intervention (Conditional Personal Health Budgets or CPHBs) in the hope of providing patients with an incentive to achieve further recovery benefits whilst also reducing the costs of their treatment. CPHB will combine the principles of contingency management (CM) and personal health budgets (PHBs). IOT clinic staff anticipate that there will be a cohort of 40-50 patients eligible for CPHB, of whom 25-35 are likely to be assessed as sufficiently stable to participate. The current study will evaluate this new intervention using a mixed methods approach known as Realistic Evaluation (RE). RE comprises 4 stages of i. hypothesis formulation; ii. data collection; iii. data analysis; and iv. data synthesis. This will include literature, policy and protocol reviewing; stakeholder consultations (n=5); analysis of routine monitoring data; qualitative interviews with clinic staff and other professionals (n=13-15); and qualitative interviews with clinic patients (n=30), all conducted during the intervention pilot period. The core aim will be to construct models, underpinned by empirical data, regarding how and why the intervention appears to work or not work for particular clients. The evaluation will be undertaken with financial support from the Pilgrim Trust and SLaM NHS Foundation Trust. If successful as a pilot, the approach may be extended to similar services in Brighton and Darlington, and funding for further research will be sought.
REC name
London - Camberwell St Giles Research Ethics Committee
REC reference
14/LO/0757
Date of REC Opinion
27 May 2014
REC opinion
Favourable Opinion