Methodological challenges conducting trials in Primary Care – lessons learned from a feasibility study of a complex intervention to enhance alcohol screening and Brief Intervention

First published: 09/05/2019 | Last updated: May 20th, 2019

Aims: Although intervention studies can improve clinical care, their success is impacted by methodological challenges. This is especially the case in trials that involve vulnerable patient groups (e.g. problem drug users).The aim of the paper is to identify methodological challenges experienced in a feasibility study of a complex intervention to enhance alcohol screening and brief intervention (SBI) among problem drug users and explore how these may be addressed in future research

Methods: We describe a case study – ‘PINTA’ – a pre-and-post feasibility study of a complex intervention to promote alcohol SBI among methadone patients, examine the key challenges encountered and how these may be addressed.

Results: Key challenges included: (1) practice recruitment, (2) patient recruitment, (3) ensuring consistent delivery of the intervention, (4) collecting follow up data. Interventions which may address these challenges in future research include: (1) adequate ‘oversampling’ to allow for recruitment challenges, (2) enhanced ‘academic detailing’ (i.e. research team situated on-site to support research enactment, (3) ensuring outcome data can be extracted from clinical records, (4) minimising additional work involved for practices.

Discussion: This paper highlights strategies which researchers may consider when designing intervention studies among problem drug users attending primary care and other vulnerable groups.

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Dr Geoff McCombe