83) Intervention n = 285 Control n = 240 Intervention n = 182 Co

83). Intervention n = 285 Control n = 240 Intervention n = 182 Control n = 153 Retention in treatment was higher in the intervention group (88%) compared to control (81%), but this was not statistically significant (P = 0.34) (Table 3). Physical health was significantly poorer in the intervention group at follow-up compared to control (adjusted P = 0.046, Table 3). Within-group changes showed the physical health of the intervention group significantly deteriorated between baseline and follow-up (P = 0.02), whilst

the control group remained relatively unchanged (P = 0.99). There was no significant difference in psychological health between the two groups at follow-up (P = 0.49, Table 3). The within group changes showed the psychological health of the intervention group significantly deteriorated between baseline and follow-up (P = 0.01), whilst the control group remained relatively unchanged (P = 0.42). There was no significant difference CHIR-99021 between groups in treatment satisfaction at follow-up (adjusted P = 0.36, Table 3). However, while there was no significant change in the control group (crude mTOR inhibitor P = 0.26), treatment satisfaction improved significantly in the intervention group (crude P = 0.03). When asked about the level of communication with pharmacists in the previous 6 months, a sizeable proportion

(41% intervention and 38% control) said there was ‘no difference’. However, more intervention than control patients said that the pharmacists had ‘spoken more’ (P = 0.056) and significantly more intervention patients found these discussions useful (P = 0.047, Table 4). Intervention n (%) Control n (%) Statistical analysis of the primary and secondary outcomes was also conducted using a per-protocol analysis but results were similar to the ITT analysis. Subgroup analysis of the main

outcome in relation to training sessions attended by pharmacists revealed no significant differences in the odds of illicit heroin use between intervention and control groups for pharmacists who had attended less than four sessions (P = 0.56) and pharmacists who had attended Non-specific serine/threonine protein kinase all four sessions (P = 0.84). Treatment satisfaction was highest among patients seen by pharmacists who had attended all four sessions, but this was not statistically significant (P = 0.84). This RCT demonstrated a reduction in illicit heroin use in both groups but no significant between-group difference. Treatment satisfaction improved significantly in the intervention group, but there was no between-group effect. Both physical and psychological health was significantly poorer in the intervention group at follow-up, which may have been due to chance or increased awareness of health. The study had strengths and limitations. The study is the largest known RCT worldwide evaluating a pharmacy intervention for drug misusers. Pharmacist recruitment was good.

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