Clinicians’ attitudes towards, and use of, computerised cognitive behaviour therapy: a research portfolio

BACKGROUND: Computerised Cognitive Behaviour Therapy (cCBT) is effective for a range of mental health difficulties but research indicates that the rate of uptake is low amongst clinicians. Most of the literature regarding cCBT tends to focus on evidence demonstrating its effectiveness or patient views of cCBT, but there is limited research looking at clinician or provider views. AIMS: The systematic review and empirical research project aimed to examine staff attitudes towards cCBT. The empirical study also aimed to establish whether constructs of Normalisation Process Theory predicted clinicians’ a) self-reported attitudes towards cCBT and b) self-reported referral behaviour regarding cCBT. METHODS: A systematic review of four electronic databases was conducted. Nineteen studies were identified for inclusion in the review and subjected to data extraction, quality assessment and narrative synthesis. For the empirical study, an online survey was completed by 246 individuals who provide psychological input to people in the UK. Stepwise regression was used to examine predictors of attitudes and referral rates. RESULTS: Findings from the systematic review indicated that clinicians were generally of the view that cCBT is acceptable and effective to an extent. No firm conclusions could be drawn regarding the rate of use of cCBT by clinicians due to the heterogeneity between studies. Similarly, the empirical study found that clinicians reported both negative and positive attitudes towards cCBT. Fewer than half of respondents had ever referred a patient to cCBT and the rates of referral were typically low. Constructs of NPT were important predictors of both attitudes and self-reported referral rates. CONCLUSIONS: The current findings indicate that clinicians exhibit mixed attitudes towards cCBT. The empirical study indicates that NPT may be a useful theory in predicting attitudes and behaviours toward healthcare interventions but additional research is required to establish whether this finding is replicable in areas beyond cCBT

Specialist Clinicians' Management of Dependence on Non-Prescription Medicines and Barriers to Treatment Provision : An Exploratory Mixed Methods Study Using Behavioural Theory

This research was funded by THE SOCIETY FOR THE STUDY OF ADDICTION in the form a PhD studentship awarded to Niamh Fingleton. Supplementary Materials: The following are available online at http://www.mdpi.com/2226-4787/7/1/25/s1, Table S1: Summary of belief statements and illustrative quotes assigned to the theoretical domainsPeer reviewedPublisher PD

'You are still a human being, you still have needs, you still have wants':a qualitative exploration of patients’ experiences and views of HIV support

Background: The importance of patient involvement in service redesign is gaining increasing recognition, particularly for chronic conditions. This study explored the experience, views and needs of people living with HIV to identify areas for improvement and service development.Methods: Face-to-face, semi-structured interviews were conducted with people living with HIV being treated in two clinics in Grampian, Scotland. The topic guide was developed, based on a proposed care pathway, which emphasized support systems. Thematic analysis was undertaken.Results: A total of 14 people living with HIV participated, with time since diagnosis ranging from 15 years. Most were males, white British and were men who had sex with men. Interviewees highlighted the need for different types of support throughout different stages of the HIV journey, including timely provision of information, post-diagnosis follow-up support, peer support, family support, and support regarding employment, benefits and housing. Many interviewees expressed a preference for support to be provided by people with knowledge or experience of HIV but had mixed feelings towards group support. Interviewees reported concerns with confidentiality and potential stigmatization.Conclusions: Support services should be tailored to reflect changing needs throughout the HIV journey with particular emphasis on maximizing confidentiality whilst minimizing stigma

Non-prescription medicine misuse, abuse and dependence : a cross-sectional survey of the UK general population

BACKGROUND: Non-prescription medicines (NPMs) can be misused, abused or lead to dependence, but the prevalence of these problems within the UK general population was unknown. The aim of this study was to estimate the prevalence of self-reported misuse, abuse and dependence to NPMs.METHODS: A cross-sectional postal survey was sent to 1000 individuals aged ≥18 randomly drawn from the UK Edited Electoral Register.RESULTS: A response rate of 43.4% was achieved. The lifetime prevalence of NPM misuse was 19.3%. Lifetime prevalence of abuse was 4.1%. Younger age, having a long-standing illness requiring regular NPM use and ever having used illicit drugs or legal highs were predictive of misuse/abuse of NPMs. In terms of dependence, lifetime prevalence was 2% with 0.8% currently dependent and 1.3% dependent in the past. Dependence was reported with analgesics (with and without codeine), sleep aids and nicotine products.CONCLUSION: Given the increasing emphasis on self-care and empowering the public to manage their health with NPMs, the findings highlight the need for improved pharmacovigilance of these medicines to maximize benefits with minimal risk. Healthcare providers need to be aware of the potential for misuse, abuse and dependence, particularly in patients with long-term illness

Specialist clinicians' practice and views regarding methadone/buprenorphine supervision and contingency management : a national survey

Peer reviewedPostprin

Treatable traits : a new paradigm for 21st century management of chronic airway diseases : Treatable Traits Down Under International Workshop report

“Treatable traits” have been proposed as a new paradigm for the management of airway diseases, particularly complex disease, which aims to apply personalised medicine to each individual to improve outcomes. Moving new treatment approaches from concepts to practice is challenging, but necessary. In an effort to accelerate progress in research and practice relating to the treatable traits approach, the Treatable Traits Down Under International Workshop was convened in Melbourne, Australia in May 2018. Here, we report the key concepts and research questions that emerged in discussions during the meeting. We propose a programme of research that involves gaining international consensus on candidate traits, recognising the prevalence of traits, and identifying a potential hierarchy of traits based on their clinical impact and responsiveness to treatment. We also reflect on research methods and designs that can generate new knowledge related to efficacy of the treatable traits approach and consider multidisciplinary models of care that may aid its implementation into practice