Analysis of sub-optimal dosing in methadone maintenance treatment
Research type
Research Study
Full title
A behavioural analysis of sub-optimal dosing in methadone maintenance treatment
IRAS ID
158767
Contact name
P Conley
Contact email
Sponsor organisation
Public Health England
Duration of Study in the UK
0 years, 2 months, 14 days
Research summary
The research is concerned with investigating the behaviours of methadone maintenance healthcare professionals and patients with respect to sub-optimal prescribing of methadone - what are the behaviours of healthcare professionals that may encourage sub-optimal dosing and what are the behaviours of patients that might lead them accept such doses or not adhere to optimal doses? Methadone maintenance treatment (MMT) for heroin addiction has a strong evidence base, however across England there appears to be a sizable fidelity gap between evidenced based practice as detailed in the relevant clinical guidelines and the real world application. This gap is manifest as large numbers of patients reporting continued illicit use of heroin whilst in MMT. Under dosing of methadone is not the only possible explanation for the high level of continued illicit heroin use that is seen. Equally there may be limitations to the efficacy of methadone itself even at an optimal dose, complimentary factors such as strength of therapeutic relationship and/or complimentary psychosocial interventions may play a significant role as too might the issue of medication adherence and the extent to which prescribed doses of methadone aren’t ingested as prescribed. Whilst the literature review associated with this research will attempt to provide contextual insight into (i) any limitations of methadone, (ii) complimentary factors and (iii) medication adherence with respect to methadone, the data collection and analysis that this application relates to is concerned only with examining the behaviours behind healthcare professionals approach to prescribing of optimal doses and patients acceptance, or otherwise, of such doses.
Healthcare professionals will be surveyed using an adapted version of Huijg’s et al medications adherence questionnaire which is a validated tool based upon the Theoretical Domains Framework. Patients will be surveyed via semi-structured interviews using questions designed around the COM-B framework, a psychological model for explaining human behaviour.
REC name
North West - Greater Manchester Central Research Ethics Committee
REC reference
14/NW/1308
Date of REC Opinion
5 Nov 2014
REC opinion
Further Information Favourable Opinion