Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-27T05:02:53.444Z Has data issue: false hasContentIssue false
  • English
  • Français

General practitioners tackle complex addictions: how complex interventions can assist in dealing with addiction

Published online by Cambridge University Press:  30 August 2016

J. Klimas Open the ORCID record for J. Klimas [Opens in a new window]
J. Klimas*
Affiliation:
British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, Vancouver, BC, Canada Department of Medicine, University of British Columbia, St. Paul’s Hospital, Vancouver, BC, Canada School of Medicine, Coombe Healthcare Centre, University College Dublin, Dolphins Barn, Dublin, Ireland
*
*Address for correspondence: J. Klimas, MSc, PhD, Associate Fellowship Director, Canada Addiction Medicine Research Fellowship, BC Centre for Excellence in HIV/AIDS, University of British Columbia, St. Paul’s Hospital, 608-1081 Burrard Street, Vancouver, BC, Canada, V6Z 1Y6. (Email: jan.klimas@ucd.ie)
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives

Substance use disorder treatment is a complex problem. Complex problems require complex interventions, ideally tested via randomised controlled trials.

Methods

Complex interventions are best developed in stages, using established implementation frameworks.

Results and Conclusions

Starting with a historical patient case study, we explore how treatment of this challenging population group has been approached, how an evidence-based framework has informed formulation of a complex health intervention and how this has been progressed via the UK’s Medical Research Council (MRC) approach.

Keywords

Complex interventionsgeneral practicemental healthsubstance-related disorders
Type
Perspective Piece
Information
Irish Journal of Psychological Medicine , Volume 35 , Issue 4 , December 2018 , pp. 329 - 331
Copyright
© College of Psychiatrists of Ireland 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Campbell, M, Fitzpatrick, R, Haines, A, Kinmonth, AL, Sandercock, P, Spiegelhalter, D, Tyrer, P (2000). Framework for design and evaluation of complex interventions to improve health. British Medical Journal 321, 694–696.Google Scholar
Cullen, W, Stanley, J, Langton, D, Kelly, Y, Staines, A, Bury, G (2006). Hepatitis c infection among injecting drug users in general practice: a cluster randomised controlled trial of clinical guidelines’ implementation. British Journal of General Practice 56, 848–856.Google Scholar
Damschroder, LJ, Aron, DC, Keith, RE, Kirsh, SR, Alexander, JA, Lowery, JC (2009). Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Science 4, 50.Google Scholar
Field, CA, Klimas, J, Barry, J, Bury, G, Keenan, E, Smyth, B, Cullen, W (2013). Problem alcohol use among problem drug users in primary care: a qualitative study of what patients think about screening and treatment. BMC Family Practice 14, 98.Google Scholar
Johnson, C, Dong, H, Ahamad, K, Hayashi, K, Milloy, MJ, Kerr, T, Wood, E (2015). Impact of binge alcohol on mortality among people who inject drugs. Addictive Behaviours Reports 2, 28–32.Google Scholar
Klimas, J, Cullen, W, Field, CA, PADU Group (2014). Problem alcohol use among problem drug users: development and content of clinical guidelines for general practice. Irish Journal of Medical Science 183, 89–101.Google Scholar
Klimas, J, O’Reilly, M, Egan, M, Tobin, H, Bury, G (2014). Urban overdose hotspots: a 12-month prospective study in Dublin ambulance services. The American Journal of Emergency Medicine 32, 1168–1173.Google Scholar
Klimas, J, Tobin, H, Field, CA, O’Gorman, CS, Glynn, LG, Keenan, E., Cullen, W (2014). Psychosocial interventions to reduce alcohol consumption in concurrent problem alcohol and illicit drug users. Cochrane Database of Systematic Reviews 12, CD009269.Google Scholar
Langton, D, Hickey, A, Bury, G, Smith, M, O’Kelly, F, Barry, J., Bourke, M (2000). Methadone maintenance in general practice: impact on staff attitudes. Irish Journal of Medical Science 169, 133–136.Google Scholar
O’Kelly, F, O’Doherty, K, Bury, G, O’Callaghan, E (1986). Heroin abuse in an inner city practice. Irish Medical Journal 79, 85–87.Google Scholar
Ryan, WJ, Arthurs, Y, Kelly, MG, Fielding, JF (1982). Heroin abuse with hepatitis b virus associated chronic active hepatitis in a twelve-year-old child: a non-fictitious pulitzer prize. Irish Medical Journal 75, 166.Google Scholar
Ryder, N, Cullen, W, Barry, J, Bury, G, Keenan, E, Smyth, BP (2009). Prevalence of problem alcohol use among patients attending primary care for methadone treatment. BMC Family Practice 10, 42.Google Scholar
Schaffalitzky, E, Leahy, D, Armstrong, C, Gavin, B, Latham, L, McNicholas, F, Cullen, W (2015). ‘Nobody really gets it’: a qualitative exploration of youth mental health in deprived urban areas. Early Intervention in Psychiatry 9, 406–411.Google Scholar