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Brief psychotherapy administered by non-specialised health workers to address risky substance use in inpatients with multi-drug resistant tuberculosis: A feasibility and acceptability study
Gregory Calligaro
University of Cape Town Faculty of Health Sciences
Corresponding Author
ORCiD: https://orcid.org/0000-0001-7324-0775
Rodney Dawson
University of Cape Town Lung Institute
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background:
Only 55% of multi-drug resistant tuberculosis (MDR-TB) cases worldwide complete treatment, with problem substance use a risk for default and treatment failure. Nevertheless, there is little research on psychotherapeutic interventions for reducing substance use among MDR-TB patients in general, and on their delivery by non-specialist health workers in particular.
Objectives:
To explore the feasibility and acceptability of a non-specialist health worker-delivered 4-session brief motivational interviewing and relapse prevention (MI-RP) intervention for problem substance use and to obtain preliminary data on the effects of this intervention on substance use severity, depressive symptoms, psychological distress and functional impairment at 3 months after hospital discharge.
Methods:
Between December 2015 and October 2016, consenting MDR-TB patients admitted to Brewelskloof Hospital who screened at moderate to severe risk for substance-related problems on the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) were enrolled, and a baseline questionnaire administered. In the four weeks prior to planned discharge, trained counsellors delivered the MI-RP intervention. The baseline questionnaire was re-administered three-months post-discharge and qualitative interviews were conducted with a randomly selected sample of participants (n=10).
Results:
Sixty patients were screened: 40 (66%) met inclusion criteria of which 39 (98%) were enrolled. Of the enrolled patients, 26 (67%) completed the counselling sessions and the final assessment. Qualitative interviews revealed participants’ perceptions of the value of the intervention. From baseline to follow-up, patients reported reductions in substance use severity, symptoms of depression, distress and functional impairment.
Conclusion:
In this feasibility study, participant retention in the study was moderate. We found preliminary evidence supporting the benefits of the intervention for reducing substance use and symptoms of psychological distress, supported by qualitative reports of patient experiences. Randomised studies are needed to demonstrate efficacy of this intervention before considering potential for wider implementation.
Trial registration: South African National Clinical Trials Register (DOH-27-0315-5007) on 01/04/2015 (http://www.sanctr.gov.za).
Keywords
Tuberculosis, adherence, counselling, substance use
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Reviewer #3 agreed
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On 26 Aug, 2020
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Received 22 Jul, 2020
Reviewer #1 agreed
On 20 Jul, 2020
Reviewers invited
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Editor invited
On 13 May, 2020
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Editor assigned
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This preprint is under consideration at Pilot and Feasibility Studies. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Brief psychotherapy administered by non-specialised health workers to address risky substance use in inpatients with multi-drug resistant tuberculosis: A feasibility and acceptability study
Gregory Calligaro
University of Cape Town Faculty of Health Sciences
Corresponding Author
ORCiD: https://orcid.org/0000-0001-7324-0775
Rodney Dawson
University of Cape Town Lung Institute
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 3
Posted 18 Dec, 2020
No community comments so far
Editor assigned
On 05 Dec, 2020
Submission checks complete
On 05 Dec, 2020
Editor invited
On 05 Dec, 2020
No comments provided
Review #2 received
Received 24 Nov, 2020
Editorial decision: Minor revision
On 24 Nov, 2020
Reviewer #2 agreed
On 18 Nov, 2020
Review #1 received
Received 15 Nov, 2020
Reviewer #1 agreed
On 11 Nov, 2020
Reviewers invited
Invitations sent on 10 Nov, 2020
Editor assigned
On 22 Oct, 2020
Submission checks complete
On 21 Oct, 2020
Editor invited
On 21 Oct, 2020
Version (no preprint)
Posted 16 Apr, 2020
Editorial decision: Major revision
On 28 Sep, 2020
Review #2 received
Received 03 Sep, 2020
Reviewer #3 agreed
On 26 Aug, 2020
Reviewer #2 agreed
On 26 Aug, 2020
Review #1 received
Received 22 Jul, 2020
Reviewer #1 agreed
On 20 Jul, 2020
Reviewers invited
Invitations sent on 28 May, 2020
Editor assigned
On 14 May, 2020
Submission checks complete
On 13 May, 2020
Editor invited
On 13 May, 2020
This version was not preprinted
No comments provided
Editor assigned
On 13 Apr, 2020
Submission checks complete
On 12 Apr, 2020
Editor invited
On 12 Apr, 2020
First submitted
On 11 Apr, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Health Economics & Outcomes Research
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background:
Only 55% of multi-drug resistant tuberculosis (MDR-TB) cases worldwide complete treatment, with problem substance use a risk for default and treatment failure. Nevertheless, there is little research on psychotherapeutic interventions for reducing substance use among MDR-TB patients in general, and on their delivery by non-specialist health workers in particular.
Objectives:
To explore the feasibility and acceptability of a non-specialist health worker-delivered 4-session brief motivational interviewing and relapse prevention (MI-RP) intervention for problem substance use and to obtain preliminary data on the effects of this intervention on substance use severity, depressive symptoms, psychological distress and functional impairment at 3 months after hospital discharge.
Methods:
Between December 2015 and October 2016, consenting MDR-TB patients admitted to Brewelskloof Hospital who screened at moderate to severe risk for substance-related problems on the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) were enrolled, and a baseline questionnaire administered. In the four weeks prior to planned discharge, trained counsellors delivered the MI-RP intervention. The baseline questionnaire was re-administered three-months post-discharge and qualitative interviews were conducted with a randomly selected sample of participants (n=10).
Results:
Sixty patients were screened: 40 (66%) met inclusion criteria of which 39 (98%) were enrolled. Of the enrolled patients, 26 (67%) completed the counselling sessions and the final assessment. Qualitative interviews revealed participants’ perceptions of the value of the intervention. From baseline to follow-up, patients reported reductions in substance use severity, symptoms of depression, distress and functional impairment.
Conclusion:
In this feasibility study, participant retention in the study was moderate. We found preliminary evidence supporting the benefits of the intervention for reducing substance use and symptoms of psychological distress, supported by qualitative reports of patient experiences. Randomised studies are needed to demonstrate efficacy of this intervention before considering potential for wider implementation.
Trial registration: South African National Clinical Trials Register (DOH-27-0315-5007) on 01/04/2015 (http://www.sanctr.gov.za).
Figure 1
Figure 1