The efficacy of a blended motivational interviewing and problem solving therapy intervention to reduce substance use among patients presenting for emergency services in South Africa: A randomized controlled trial

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dc.contributor.authorSorsdahl, K
dc.contributor.authorStein, Dan J
dc.contributor.authorCorrigall, J
dc.contributor.authorCuijpers, P
dc.contributor.authorSmits, N
dc.contributor.authorNaledi, T
dc.contributor.authorMyers, B
dc.date.accessioned2015-12-07T03:44:28Z
dc.date.available2015-12-07T03:44:28Z
dc.date.issued2015-11-14
dc.date.updated2015-11-17T19:03:08Z
dc.description.abstractBackground: The treatment of substance use disorders is a public health priority, particularly in South Africa where the prevalence of these disorders is high. We tested two peer-counsellor delivered brief interventions (BIs) for risky substance use among adults presenting to emergency departments (EDs) in South Africa. Methods: In this randomised controlled trial, we enrolled patients presenting to one of three 24-hour EDs who screened at risk for substance use according to the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST). Eligible patients were randomly allocated to one of three conditions: Motivational Interviewing (MI), blended MI and Problem Solving Therapy (MI-PST) or a Psycho-educational Control Group (CG). The primary outcome was reduction in ASSIST scores at three months follow-up. Results: Of the 2736 patients screened, 335 met inclusion criteria, were willing to participate in the intervention and were randomised to one of three conditions: 113 to MI, 112 to MI-PST and 110 to CG. ASSIST scores at three months were lower in the MI-PST group than they were in the MI and CG groups (adjusted mean difference of −1.72, 95 % CI −3.36 - -0.08). We recorded no significant difference in ASSIST scores between the CG and MI group (adjusted mean difference of −0.02, 95 % CI −2.01 - 1.96). Conclusion: With the addition of minimal resources, BIs are feasible to conduct in EDs in a low resourced country. These preliminary findings report that MI-PST appears to be an effective BI for reducing substance use among at risk participants. Further research is required to replicate these findings with effort to limit attrition, to determine whether reductions in substance use are persistent at 6 and 12 month follow-up and whether parallel changes occur in other indications of treatment outcomes, such as injury rates and ED presentations. Trial registration: This trial registered with the Pan African Clinical Trial Registry (PACTR201308000591418)
dc.identifier.apacitationSorsdahl, K., Stein, D. J., Corrigall, J., Cuijpers, P., Smits, N., Naledi, T., & Myers, B. (2015). The efficacy of a blended motivational interviewing and problem solving therapy intervention to reduce substance use among patients presenting for emergency services in South Africa: A randomized controlled trial. http://hdl.handle.net/11427/15619en_ZA
dc.identifier.chicagocitationSorsdahl, K, Dan J Stein, J Corrigall, P Cuijpers, N Smits, T Naledi, and B Myers "The efficacy of a blended motivational interviewing and problem solving therapy intervention to reduce substance use among patients presenting for emergency services in South Africa: A randomized controlled trial." (2015) http://hdl.handle.net/11427/15619en_ZA
dc.identifier.citationSorsdahl, K., Stein, D. J., Corrigall, J., Cuijpers, P., Smits, N., Naledi, T., & Myers, B. (2015). The efficacy of a blended motivational interviewing and problem solving therapy intervention to reduce substance use among patients presenting for emergency services in South Africa: A randomized controlled trial. Substance abuse treatment, prevention, and policy, 10(1), 46.
dc.identifier.ris TY - Journal Article AU - Sorsdahl, K AU - Stein, Dan J AU - Corrigall, J AU - Cuijpers, P AU - Smits, N AU - Naledi, T AU - Myers, B AB - Background: The treatment of substance use disorders is a public health priority, particularly in South Africa where the prevalence of these disorders is high. We tested two peer-counsellor delivered brief interventions (BIs) for risky substance use among adults presenting to emergency departments (EDs) in South Africa. Methods: In this randomised controlled trial, we enrolled patients presenting to one of three 24-hour EDs who screened at risk for substance use according to the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST). Eligible patients were randomly allocated to one of three conditions: Motivational Interviewing (MI), blended MI and Problem Solving Therapy (MI-PST) or a Psycho-educational Control Group (CG). The primary outcome was reduction in ASSIST scores at three months follow-up. Results: Of the 2736 patients screened, 335 met inclusion criteria, were willing to participate in the intervention and were randomised to one of three conditions: 113 to MI, 112 to MI-PST and 110 to CG. ASSIST scores at three months were lower in the MI-PST group than they were in the MI and CG groups (adjusted mean difference of −1.72, 95 % CI −3.36 - -0.08). We recorded no significant difference in ASSIST scores between the CG and MI group (adjusted mean difference of −0.02, 95 % CI −2.01 - 1.96). Conclusion: With the addition of minimal resources, BIs are feasible to conduct in EDs in a low resourced country. These preliminary findings report that MI-PST appears to be an effective BI for reducing substance use among at risk participants. Further research is required to replicate these findings with effort to limit attrition, to determine whether reductions in substance use are persistent at 6 and 12 month follow-up and whether parallel changes occur in other indications of treatment outcomes, such as injury rates and ED presentations. Trial registration: This trial registered with the Pan African Clinical Trial Registry (PACTR201308000591418) DA - 2015-11-14 DB - OpenUCT DO - 10.1186/s13011-015-0042-1 DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2015 T1 - The efficacy of a blended motivational interviewing and problem solving therapy intervention to reduce substance use among patients presenting for emergency services in South Africa: A randomized controlled trial TI - The efficacy of a blended motivational interviewing and problem solving therapy intervention to reduce substance use among patients presenting for emergency services in South Africa: A randomized controlled trial UR - http://hdl.handle.net/11427/15619 ER - en_ZA
dc.identifier.urihttp://dx.doi.org/10.1186/s13011-015-0042-1
dc.identifier.urihttp://hdl.handle.net/11427/15619
dc.identifier.vancouvercitationSorsdahl K, Stein DJ, Corrigall J, Cuijpers P, Smits N, Naledi T, et al. The efficacy of a blended motivational interviewing and problem solving therapy intervention to reduce substance use among patients presenting for emergency services in South Africa: A randomized controlled trial. 2015; http://hdl.handle.net/11427/15619.en_ZA
dc.language.rfc3066en
dc.publisher.departmentDepartment of Public Health and Family Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rights.holderSorsdahl et al.
dc.titleThe efficacy of a blended motivational interviewing and problem solving therapy intervention to reduce substance use among patients presenting for emergency services in South Africa: A randomized controlled trial
dc.typeJournal Article
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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