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The effects of motivational interviewing on patients with comorbid substance use admitted to a psychiatric emergency unit - a randomised controlled trial with two year follow-up.

ABSTRACT: The prevalence of substance use in people acutely admitted to in-patient psychiatric wards is high and the patients` duration of stay is limited. Motivational interviewing is a method with evidence based effect in short interventions. The aims of the present study were to compare the effects of 2 sessions of motivational interviewing and treatment as usual (intervention group) with treatment as usual only (control group) on adult patients with comorbid substance use admitted to a psychiatric in-patient emergency unit.This was an open randomised controlled trial including 135 patients where substance use influenced the admittance. After admission and assessments, the patients were allocated to the intervention group (n = 67) or the control group (n = 68). The primary outcome was self-reported days per month of substance use during the last 3 months at 3, 6, 12 and 24 months after inclusion. Data was analysed with a multilevel linear repeated measures regression model.Both groups reduced substance use during the first 12 months with no substantial difference between the 2 groups. At 2 year follow-up, the control group had increased their substance use with 2.4 days (95% confidence interval (CI) -1.5 to 6.3), whereas the intervention group had reduced their monthly substance use with 4.9 days (95% CI 1.2 to 8.6) compared to baseline. The 2 year net difference was 7.3 days of substance use per month (95% CI 1.9 to 12.6, p < 0.01) in favour of the intervention group.The present study suggests that 2 sessions of motivational interviewing to patients with comorbid substance use admitted to a psychiatric emergency unit reduce substance use frequency substantially at 2 year follow-up.ClinicalTrials.gov Identifier: NCT00184223.

SUBMITTER: Bagoien G

PROVIDER: S-EPMC3618135 | biostudies-literature | 2013 Mar

REPOSITORIES: biostudies-literature

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The effects of motivational interviewing on patients with comorbid substance use admitted to a psychiatric emergency unit - a randomised controlled trial with two year follow-up.

Bagøien Gunnhild G Bjørngaard Johan Håkon JH Østensen Christine C Reitan Solveig Klæbo SK Romundstad Pål P Morken Gunnar G

BMC psychiatry 20130321

<h4>Background</h4>The prevalence of substance use in people acutely admitted to in-patient psychiatric wards is high and the patients` duration of stay is limited. Motivational interviewing is a method with evidence based effect in short interventions. The aims of the present study were to compare the effects of 2 sessions of motivational interviewing and treatment as usual (intervention group) with treatment as usual only (control group) on adult patients with comorbid substance use admitted t ...[more]

PMID: 23517244

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Project description:BackgroundGeneral medical hospitals provide care for a disproportionate share of patients who misuse substances. Hospitalization provides a unique opportunity to identify and motivate patients to address their substance misuse.ObjectiveTo determine the effectiveness of three strategies for implementing motivational interviewing for substance misuse with general medical inpatients.DesignType 3 hybrid effectiveness-implementation randomized controlled trial (Clinical Trials.gov: NCT01825057).ParticipantsThirty-eight providers (physicians, physician assistants, nurses) from 13 general medical inpatient services, and 1173 of their patients admitted to an academically affiliated acute care hospital.InterventionsImplementation strategies included (1) a continuing medical education workshop on detection of substance misuse and provision of a motivational interview; (2) workshop plus bedside supervision (apprenticeship condition); and (3) a workshop plus ability to place a medical order for an interview from a consultation-liaison service (consult condition).Main measuresPrimary outcomes were the percentage of study-eligible patients who received an interview for substance misuse and the integrity (adherence, competence) of the interviews. The secondary outcome was the percent of patient statements within the interviews that indicated motivation for reducing substance misuse.Key results20.5% of patients in the consult condition received an interview, compared to 0.8% (Hedge's g = 1.49) and 3.0% (Hedge's g = 1.26) in the respective workshop only and apprenticeship conditions (p < 0.001). Motivational interviews in the consult condition were performed with more fundamental motivational interviewing adherence and competence than the other conditions. Most statements made by patients during the interviews favored reducing substance misuse, with no differences between conditions.ConclusionsProviders' ability to place an order to have experts from the consultation-liaison service deliver a motivational interview was a more effective implementation strategy than a workshop or apprenticeship method for ensuring motivational interviewing is available to medical inpatients who misuse substances.Trial registryNCT01825057.

Dataset Information

The effects of motivational interviewing on patients with comorbid substance use admitted to a psychiatric emergency unit - a randomised controlled trial with two year follow-up.

Publications

The effects of motivational interviewing on patients with comorbid substance use admitted to a psychiatric emergency unit - a randomised controlled trial with two year follow-up.

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