Brief Intervention for Hospitalized Patients with Problematic Prescription Drug Use: No Long-lasting Effects

Prescription drug (PD) misuse is a challenging problem. This randomized controlled trial tested whether a brief intervention (BI) involving 2 sessions of motivational interviewing could reduce problematic PD use among 126 inpatients at a German university hospital. Problematic use was defined as having a prior diagnosis of prescription drug dependence or abuse or as taking nonprescribed potentially addictive medication for at least 60 of the 90 days preceding baseline screening. The first session of the intervention was conducted while the patients were hospitalized; the second took place 4 weeks later. A prior report, described in the March–April 2009 issue of this newsletter, showed a reduction in PD use at 3 months following the intervention. This study examined 2 outcomes—cessation of PD use and 25% reduction in use—at 12 months. Analyses controlled for baseline differences in PD dependence and duration of use.

• There was no difference in cessation rates between the BI and control groups at 12 months (25% versus 20%; odds ratio [OR], 1.4).

• There was no difference in proportion of patients who reduced their drug use by at least 25% at 12 months (50% versus 49%; OR, 0.9).

Comments:

Although application of the BI model for problematic PD use is appealing, in this study, BI had no effect on use of potentially addictive medications at 12 months. Whether a more intensive or long-standing intervention is needed for hospitalized patients with PD use, who are generally sicker than patients with risky alcohol use in ambulatory settings (the group for which BI was originally developed), remains an important area for investigation.

Hillary Kunins, MD, MPH, MS

Reference:

Otto C, Crackau B, Löhrmann I, et al. Brief intervention in general hospital for problematic prescription drug use: 12-month outcome. Drug Alcohol Depend. 2009;105(3):221–226.