Pharmacist and Homeless Outreach Engagement and Non-medical Independent prescribing Rx (PHOENIx): a study protocol for a pilot randomised controlled trial

Lowrie, R. et al. (2022) Pharmacist and Homeless Outreach Engagement and Non-medical Independent prescribing Rx (PHOENIx): a study protocol for a pilot randomised controlled trial. BMJ Open, 12(12), e064792. (doi: 10.1136/bmjopen-2022-064792) (PMID:36526321) (PMCID:PMC9764622)

Abstract

Introduction: The number of people experiencing homelessness (PEH) is increasing worldwide. Systematic reviews show high levels of multimorbidity and mortality. Integrated health and social care outreach interventions may improve outcomes. No previous studies have targeted PEH with recent drug overdose despite high levels of drug-related deaths and few data describe their health/social care problems. Feasibility work suggests a collaborative health and social care intervention (Pharmacist and Homeless Outreach Engagement and Non-medical Independent prescribing Rx, PHOENIx) is potentially beneficial. We describe the methods of a pilot randomised controlled trial (RCT) with parallel process and economic evaluation of PEH with recent overdose. Methods and analysis: Detailed health and social care information will be collected before randomisation to care-as-usual plus visits from a pharmacist and a homeless outreach worker (PHOENIx) for 6–9 months or to care-as-usual. The outcomes are the rates of presentations to emergency department for overdose or other causes and whether to progress to a definitive RCT: recruitment of ≥100 participants within 4 months, ≥60% of patients remaining in the study at 6 and 9 months, ≥60% of patients receiving the intervention, and ≥80% of patients with data collected. The secondary outcomes include health-related quality of life, hospitalisations, treatment uptake and patient-reported measures. Semistructured interviews will explore the future implementation of PHOENIx, the reasons for overdose and protective factors. We will assess the feasibility of conducting a cost-effectiveness analysis. Ethics and dissemination: The study was approved by South East Scotland National Health Service Research Ethics Committee 01. Results will be made available to PEH, the study funders and other researchers.

• Item Type: Articles
• Additional Information: Funding This work was supported by the Population Health Directorate (Health Improvement Division) of the Scottish Government: Drug Deaths Taskforce (grant award DDTFRF06) on 30 July 2020.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Maguire, Donogh and Duncan, Dr Clare and Mair, Professor Frances and Lowrie, Dr Richard and Williamson, Professor Andrea and McPherson, Dr Andrew
• Authors: Lowrie, R., McPherson, A., Mair, F., Maguire, D., Paudyal, V., Blair, B., Brannan, D., Moir, J., Hughes, F., Duncan, C., Stock, K., Farmer, N., Ramage, R., Lombard, C., Ross, S., Scott, A., Provan, G., Sills, L., Hislop, J., Reilly, F., and Williamson, A. E.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: BMJ Open
• Publisher: BMJ Publishing Group
• ISSN: 2044-6055
• ISSN (Online): 2044-6055
• Published Online: 16 December 2022
• Copyright Holders: Copyright © Author(s) (or their employer(s)) 2022
• First Published: First published in BMJ Open 12(12): e064792
• Publisher Policy: Reproduced under a Creative Commons License