Holistic health and social care outreach for people experiencing homelessness with recent non-fatal overdose in Glasgow, Scotland: the Pharmacist and third sector Homeless charity worker Outreach Engagement Non-medical Independent prescriber Rx (PHOENIx) pilot randomised controlled trial
Objectives To examine randomised controlled trial (RCT) progression criteria including emergency department (ED) attendance and non-fatal overdose, from a holistic, integrated health and social care outreach intervention (PHOENIx), for people experiencing homelessness with recent non-fatal street dr...
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BMJ Publishing Group
2024-07-01
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| Series: | BMJ Public Health |
| Online Access: | https://bmjpublichealth.bmj.com/content/2/1/e000219.full |
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| author | Vibhu Paudyal Nicola Greenlaw Frances S Mair Kate Stock Andrew McPherson Andrea E Williamson Richard Lowrie Donogh Maguire Steven Ross James Roy Robertson Alison Boyle Clare Duncan Rebecca Blair Cian Lombard Fiona Hughes Jane Moir Ailsa Scott Frank Reilly Laura Sills Jennifer Hislop Stephen Wishart David Brannan Rebekah Ramage |
| author_facet | Vibhu Paudyal Nicola Greenlaw Frances S Mair Kate Stock Andrew McPherson Andrea E Williamson Richard Lowrie Donogh Maguire Steven Ross James Roy Robertson Alison Boyle Clare Duncan Rebecca Blair Cian Lombard Fiona Hughes Jane Moir Ailsa Scott Frank Reilly Laura Sills Jennifer Hislop Stephen Wishart David Brannan Rebekah Ramage |
| author_sort | Vibhu Paudyal |
| collection | DOAJ |
| description | Objectives To examine randomised controlled trial (RCT) progression criteria including emergency department (ED) attendance and non-fatal overdose, from a holistic, integrated health and social care outreach intervention (PHOENIx), for people experiencing homelessness with recent non-fatal street drug overdose.Design Pilot RCT. 1:1 randomisation to PHOENIx plus usual care (UC) or UC.Setting Glasgow, Scotland.Participants 128 adults experiencing homelessness with at least one non-fatal street drug overdose in the preceding 6 months.Interventions Pharmacists from the National Health Service and third sector homelessness workers offered weekly outreach. PHOENIx teams develop therapeutic relationships to address health (physical health, mental health and problem drug use) and social care (housing, welfare benefits and social prescribing) in addition to UC. UC comprised building-based primary and secondary health, social and third sector services.Outcomes Primary: progression criteria: recruitment (≥100 participants in 4 months); ≥80% of participants with data collected at baseline, 6 and 9 months; ≥60% of participants retained in the trial at each follow-up period (6 and 9 months); ≥60% of participants receiving the intervention weekly; any reduction in the rate of presentation to ED and overdoses, at 6- or 9-month follow-up. Secondary: participants with, and time to: hospitalisations; health-related quality of life (QoL); treatment uptake for physical and mental health conditions, and problematic drug use.Results Progression criteria were exceeded. In PHOENIx compared with UC, there appeared to be a delay in the median time to ED visit, overdose and hospitalisation but no improvement in number of participants with ED visits, overdoses or hospitalisations. QoL and treatment uptake appeared to be higher in PHOENIx versus UC at 6 and 9 months.Conclusions A definitive RCT is merited, to assess the impact of PHOENIx on people with multiple, severe disadvantages.Trial registration number ISRCTN10585019. |
| format | Article |
| id | doaj-art-f90d80a240274751bde42ab915b82dfd |
| institution | Kabale University |
| issn | 2753-4294 |
| language | English |
| publishDate | 2024-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Public Health |
| spelling | doaj-art-f90d80a240274751bde42ab915b82dfd2025-01-28T21:15:09ZengBMJ Publishing GroupBMJ Public Health2753-42942024-07-012110.1136/bmjph-2023-000219Holistic health and social care outreach for people experiencing homelessness with recent non-fatal overdose in Glasgow, Scotland: the Pharmacist and third sector Homeless charity worker Outreach Engagement Non-medical Independent prescriber Rx (PHOENIx) pilot randomised controlled trialVibhu Paudyal0Nicola Greenlaw1Frances S Mair2Kate Stock3Andrew McPherson4Andrea E Williamson5Richard Lowrie6Donogh Maguire7Steven Ross8James Roy Robertson9Alison Boyle10Clare Duncan11Rebecca Blair12Cian Lombard13Fiona Hughes14Jane Moir15Ailsa Scott16Frank Reilly17Laura Sills18Jennifer Hislop19Stephen Wishart20David Brannan21Rebekah Ramage22Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King`s College, London, EnglandRobertson Centre for Biostatistics, University of Glasgow, Glasgow, UKPrimary Care, University of Glasgow, Glasgow, UKPharmacy and Prescribing Support, NHS Greater Glasgow and Clyde, Glasgow, UKPharmacy and Prescribing Support, NHS Greater Glasgow and Clyde, Glasgow, UKGeneral Practice and Primary Care, School of Medicine, College of MVLS, University of Glasgow, Glasgow, UKPharmacy Services, NHS Greater Glasgow and Clyde, Glasgow, Glasgow, UKEmergency Medicine Department, Glasgow Royal Infirmary, Glasgow, UKSimon Community Scotland, Glasgow, UKMuirhouse Medical Group, Edinburgh, UKPharmacy and Prescribing Support, NHS Greater Glasgow and Clyde, Glasgow, UKAddictions Psychiatry, Crosshouse Hospital, Kilmarnock, UKPharmacy and Prescribing Support, NHS Greater Glasgow and Clyde, Glasgow, UKPharmacy and Prescribing Support, NHS Greater Glasgow and Clyde, Glasgow, UKPharmacy and Prescribing Support, NHS Greater Glasgow and Clyde, Glasgow, UKPharmacy and Prescribing Support, NHS Greater Glasgow and Clyde, Glasgow, UKSimon Community Scotland, Glasgow, UKSimon Community Scotland, Glasgow, UKNHS Greater Glasgow and Clyde Homelessness Health Services, Glasgow, UKHealthcare Improvement Scotland Glasgow, Glasgow, UKShelter Scotland, Glasgow, UKThe Marie Trust, Glasgow, UKPharmacy and Prescribing Support, NHS Greater Glasgow and Clyde, Glasgow, UKObjectives To examine randomised controlled trial (RCT) progression criteria including emergency department (ED) attendance and non-fatal overdose, from a holistic, integrated health and social care outreach intervention (PHOENIx), for people experiencing homelessness with recent non-fatal street drug overdose.Design Pilot RCT. 1:1 randomisation to PHOENIx plus usual care (UC) or UC.Setting Glasgow, Scotland.Participants 128 adults experiencing homelessness with at least one non-fatal street drug overdose in the preceding 6 months.Interventions Pharmacists from the National Health Service and third sector homelessness workers offered weekly outreach. PHOENIx teams develop therapeutic relationships to address health (physical health, mental health and problem drug use) and social care (housing, welfare benefits and social prescribing) in addition to UC. UC comprised building-based primary and secondary health, social and third sector services.Outcomes Primary: progression criteria: recruitment (≥100 participants in 4 months); ≥80% of participants with data collected at baseline, 6 and 9 months; ≥60% of participants retained in the trial at each follow-up period (6 and 9 months); ≥60% of participants receiving the intervention weekly; any reduction in the rate of presentation to ED and overdoses, at 6- or 9-month follow-up. Secondary: participants with, and time to: hospitalisations; health-related quality of life (QoL); treatment uptake for physical and mental health conditions, and problematic drug use.Results Progression criteria were exceeded. In PHOENIx compared with UC, there appeared to be a delay in the median time to ED visit, overdose and hospitalisation but no improvement in number of participants with ED visits, overdoses or hospitalisations. QoL and treatment uptake appeared to be higher in PHOENIx versus UC at 6 and 9 months.Conclusions A definitive RCT is merited, to assess the impact of PHOENIx on people with multiple, severe disadvantages.Trial registration number ISRCTN10585019.https://bmjpublichealth.bmj.com/content/2/1/e000219.full |
| spellingShingle | Vibhu Paudyal Nicola Greenlaw Frances S Mair Kate Stock Andrew McPherson Andrea E Williamson Richard Lowrie Donogh Maguire Steven Ross James Roy Robertson Alison Boyle Clare Duncan Rebecca Blair Cian Lombard Fiona Hughes Jane Moir Ailsa Scott Frank Reilly Laura Sills Jennifer Hislop Stephen Wishart David Brannan Rebekah Ramage Holistic health and social care outreach for people experiencing homelessness with recent non-fatal overdose in Glasgow, Scotland: the Pharmacist and third sector Homeless charity worker Outreach Engagement Non-medical Independent prescriber Rx (PHOENIx) pilot randomised controlled trial BMJ Public Health |
| title | Holistic health and social care outreach for people experiencing homelessness with recent non-fatal overdose in Glasgow, Scotland: the Pharmacist and third sector Homeless charity worker Outreach Engagement Non-medical Independent prescriber Rx (PHOENIx) pilot randomised controlled trial |
| title_full | Holistic health and social care outreach for people experiencing homelessness with recent non-fatal overdose in Glasgow, Scotland: the Pharmacist and third sector Homeless charity worker Outreach Engagement Non-medical Independent prescriber Rx (PHOENIx) pilot randomised controlled trial |
| title_fullStr | Holistic health and social care outreach for people experiencing homelessness with recent non-fatal overdose in Glasgow, Scotland: the Pharmacist and third sector Homeless charity worker Outreach Engagement Non-medical Independent prescriber Rx (PHOENIx) pilot randomised controlled trial |
| title_full_unstemmed | Holistic health and social care outreach for people experiencing homelessness with recent non-fatal overdose in Glasgow, Scotland: the Pharmacist and third sector Homeless charity worker Outreach Engagement Non-medical Independent prescriber Rx (PHOENIx) pilot randomised controlled trial |
| title_short | Holistic health and social care outreach for people experiencing homelessness with recent non-fatal overdose in Glasgow, Scotland: the Pharmacist and third sector Homeless charity worker Outreach Engagement Non-medical Independent prescriber Rx (PHOENIx) pilot randomised controlled trial |
| title_sort | holistic health and social care outreach for people experiencing homelessness with recent non fatal overdose in glasgow scotland the pharmacist and third sector homeless charity worker outreach engagement non medical independent prescriber rx phoenix pilot randomised controlled trial |
| url | https://bmjpublichealth.bmj.com/content/2/1/e000219.full |
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