A pilot cluster randomised trial of the Medicines and Alcohol Consultation (MAC): an intervention to discuss alcohol use in community pharmacy medicine review services
Background: Alcohol interventions are important to the developing public health role of community pharmacies. The Medicines and Alcohol Consultation (MAC) is a new intervention, co-produced with community pharmacists (CPs) and patients, which involves a CP practice development programme designed t...
| Main Authors: | , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020
|
| Subjects: | |
| Online Access: | https://repository.londonmet.ac.uk/6155/1/s12913-020-05797-z.pdf |
| _version_ | 1825625525898444800 |
|---|---|
| author | Stewart, Duncan Van Dongen, Anne Watson, Michelle Mandefield, Laura Atkin, Karl Dhital, Ranjita Foster, Brent Gough, Brendan Hewitt, Catherine Madden, Mary Morris, Stephanie O'Carroll, Ronan Ogden, Margaret Parrott, Steve Watson, Judith White, Sue Whittlesea, Cate McCambridge, Jim |
| author_facet | Stewart, Duncan Van Dongen, Anne Watson, Michelle Mandefield, Laura Atkin, Karl Dhital, Ranjita Foster, Brent Gough, Brendan Hewitt, Catherine Madden, Mary Morris, Stephanie O'Carroll, Ronan Ogden, Margaret Parrott, Steve Watson, Judith White, Sue Whittlesea, Cate McCambridge, Jim |
| author_sort | Stewart, Duncan |
| collection | LMU |
| description | Background:
Alcohol interventions are important to the developing public health role of community pharmacies. The Medicines and Alcohol Consultation (MAC) is a new intervention, co-produced with community pharmacists (CPs) and patients, which involves a CP practice development programme designed to integrate discussion of alcohol within existing NHS medicine review services. We conducted a pilot trial of the MAC and its delivery to investigate all study procedures to inform progression to a definitive trial.
Methods:
This cluster pilot RCT was conducted in 10 community pharmacies in Yorkshire, UK, with a CP from each who regularly conducted Medicine Use Review (MUR) and New Medicine Service (NMS) consultations. Randomisation was conducted using a secure remote randomisation service. Intervention CPs (n = 5) were trained to deliver the MAC in MUR/NMS consultations. Control CPs (n = 5) provided these services as usual. Consecutive MUR/NMS patients were asked by CPs to participate, screened for eligibility (consumption of alcohol at least twice per week), and baseline data collected for those eligible. A two-month follow-up telephone interview was conducted. Blinding of CPs was not possible, but patients were blinded to the alcohol focus of the trial. Primary outcomes were total weekly UK units (8 g of ethanol per unit) of alcohol consumption in the week prior to follow-up, and confidence in medications management. Trial procedures were assessed by recruitment, attrition, and follow-up rates.
Results:
260 patients were approached by CPs to take part in the trial, 68% (n = 178) were assessed for eligibility and 30% (n = 54) of these patients were eligible. Almost all eligible patients (n = 51; 94%) consented to participate, of whom 92% (n = 47) were followed-up at 2 months; alcohol consumption was lower in the intervention arm and confidence in medication management reduced slightly for both groups. Exploration of recall issues at follow-up showed a high level of agreement between a two-item quantity/frequency measure and 7-day guided recall of alcohol consumption.
Conclusions:
The pilot trial demonstrates the feasibility of implementing the MAC in community pharmacy and trial recruitment and data collection procedures. However, decommissioning of MURs means that it is not possible to conduct a definitive trial of the intervention in this service.
Trial registration:
ISRCTN57447996 |
| first_indexed | 2024-07-09T04:01:17Z |
| format | Article |
| id | oai:repository.londonmet.ac.uk:6155 |
| institution | London Metropolitan University |
| language | English |
| last_indexed | 2024-07-09T04:01:17Z |
| publishDate | 2020 |
| publisher | BMC |
| record_format | eprints |
| spelling | oai:repository.londonmet.ac.uk:61552020-11-03T10:49:38Z https://repository.londonmet.ac.uk/6155/ A pilot cluster randomised trial of the Medicines and Alcohol Consultation (MAC): an intervention to discuss alcohol use in community pharmacy medicine review services Stewart, Duncan Van Dongen, Anne Watson, Michelle Mandefield, Laura Atkin, Karl Dhital, Ranjita Foster, Brent Gough, Brendan Hewitt, Catherine Madden, Mary Morris, Stephanie O'Carroll, Ronan Ogden, Margaret Parrott, Steve Watson, Judith White, Sue Whittlesea, Cate McCambridge, Jim 360 Social problems & services; associations 610 Medicine & health Background: Alcohol interventions are important to the developing public health role of community pharmacies. The Medicines and Alcohol Consultation (MAC) is a new intervention, co-produced with community pharmacists (CPs) and patients, which involves a CP practice development programme designed to integrate discussion of alcohol within existing NHS medicine review services. We conducted a pilot trial of the MAC and its delivery to investigate all study procedures to inform progression to a definitive trial. Methods: This cluster pilot RCT was conducted in 10 community pharmacies in Yorkshire, UK, with a CP from each who regularly conducted Medicine Use Review (MUR) and New Medicine Service (NMS) consultations. Randomisation was conducted using a secure remote randomisation service. Intervention CPs (n = 5) were trained to deliver the MAC in MUR/NMS consultations. Control CPs (n = 5) provided these services as usual. Consecutive MUR/NMS patients were asked by CPs to participate, screened for eligibility (consumption of alcohol at least twice per week), and baseline data collected for those eligible. A two-month follow-up telephone interview was conducted. Blinding of CPs was not possible, but patients were blinded to the alcohol focus of the trial. Primary outcomes were total weekly UK units (8 g of ethanol per unit) of alcohol consumption in the week prior to follow-up, and confidence in medications management. Trial procedures were assessed by recruitment, attrition, and follow-up rates. Results: 260 patients were approached by CPs to take part in the trial, 68% (n = 178) were assessed for eligibility and 30% (n = 54) of these patients were eligible. Almost all eligible patients (n = 51; 94%) consented to participate, of whom 92% (n = 47) were followed-up at 2 months; alcohol consumption was lower in the intervention arm and confidence in medication management reduced slightly for both groups. Exploration of recall issues at follow-up showed a high level of agreement between a two-item quantity/frequency measure and 7-day guided recall of alcohol consumption. Conclusions: The pilot trial demonstrates the feasibility of implementing the MAC in community pharmacy and trial recruitment and data collection procedures. However, decommissioning of MURs means that it is not possible to conduct a definitive trial of the intervention in this service. Trial registration: ISRCTN57447996 BMC 2020-10-12 Article PeerReviewed text en cc_by_4 https://repository.londonmet.ac.uk/6155/1/s12913-020-05797-z.pdf Stewart, Duncan, Van Dongen, Anne, Watson, Michelle, Mandefield, Laura, Atkin, Karl, Dhital, Ranjita, Foster, Brent, Gough, Brendan, Hewitt, Catherine, Madden, Mary, Morris, Stephanie, O'Carroll, Ronan, Ogden, Margaret, Parrott, Steve, Watson, Judith, White, Sue, Whittlesea, Cate and McCambridge, Jim (2020) A pilot cluster randomised trial of the Medicines and Alcohol Consultation (MAC): an intervention to discuss alcohol use in community pharmacy medicine review services. BMC Health Services Research, 20 (943). ISSN 1472-6963 https://doi.org/10.1186/s12913-020-05797-z 10.1186/s12913-020-05797-z 10.1186/s12913-020-05797-z |
| spellingShingle | 360 Social problems & services; associations 610 Medicine & health Stewart, Duncan Van Dongen, Anne Watson, Michelle Mandefield, Laura Atkin, Karl Dhital, Ranjita Foster, Brent Gough, Brendan Hewitt, Catherine Madden, Mary Morris, Stephanie O'Carroll, Ronan Ogden, Margaret Parrott, Steve Watson, Judith White, Sue Whittlesea, Cate McCambridge, Jim A pilot cluster randomised trial of the Medicines and Alcohol Consultation (MAC): an intervention to discuss alcohol use in community pharmacy medicine review services |
| title | A pilot cluster randomised trial of the Medicines and Alcohol Consultation (MAC): an intervention to discuss alcohol use in community pharmacy medicine review services |
| title_full | A pilot cluster randomised trial of the Medicines and Alcohol Consultation (MAC): an intervention to discuss alcohol use in community pharmacy medicine review services |
| title_fullStr | A pilot cluster randomised trial of the Medicines and Alcohol Consultation (MAC): an intervention to discuss alcohol use in community pharmacy medicine review services |
| title_full_unstemmed | A pilot cluster randomised trial of the Medicines and Alcohol Consultation (MAC): an intervention to discuss alcohol use in community pharmacy medicine review services |
| title_short | A pilot cluster randomised trial of the Medicines and Alcohol Consultation (MAC): an intervention to discuss alcohol use in community pharmacy medicine review services |
| title_sort | pilot cluster randomised trial of the medicines and alcohol consultation mac an intervention to discuss alcohol use in community pharmacy medicine review services |
| topic | 360 Social problems & services; associations 610 Medicine & health |
| url | https://repository.londonmet.ac.uk/6155/1/s12913-020-05797-z.pdf |
| work_keys_str_mv | AT stewartduncan apilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices AT vandongenanne apilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices AT watsonmichelle apilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices AT mandefieldlaura apilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices AT atkinkarl apilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices AT dhitalranjita apilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices AT fosterbrent apilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices AT goughbrendan apilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices AT hewittcatherine apilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices AT maddenmary apilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices AT morrisstephanie apilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices AT ocarrollronan apilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices AT ogdenmargaret apilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices AT parrottsteve apilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices AT watsonjudith apilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices AT whitesue apilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices AT whittleseacate apilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices AT mccambridgejim apilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices AT stewartduncan pilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices AT vandongenanne pilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices AT watsonmichelle pilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices AT mandefieldlaura pilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices AT atkinkarl pilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices AT dhitalranjita pilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices AT fosterbrent pilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices AT goughbrendan pilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices AT hewittcatherine pilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices AT maddenmary pilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices AT morrisstephanie pilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices AT ocarrollronan pilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices AT ogdenmargaret pilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices AT parrottsteve pilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices AT watsonjudith pilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices AT whitesue pilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices AT whittleseacate pilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices AT mccambridgejim pilotclusterrandomisedtrialofthemedicinesandalcoholconsultationmacaninterventiontodiscussalcoholuseincommunitypharmacymedicinereviewservices |