Improving outcomes in the treatment of opioid dependence (IOTOD): reflections on the impact of a medical education initiative on healthcare professionals’ attitudes and clinical practice

Figures & data

Figure 1. Interventions to reduce the risk of opioid-related deaths require a constellation of efforts. Figure from European Monitoring Centre for Drugs and Drug Addiction (2017), Health and social responses to drug problems.

Table 1. Summary of attendee profession 2011–2017.

	2011	2012	2013	2015	2016	2017	Total	Total (%)
Psychiatrist	50	125	65	20	44	60	364	27.0
GP	43	118	55	21	23	52	312	23.1
Addictions specialist	–	–	–	110	75	92	277	20.5
Nurse	9	19	10	11	21	36	106	7.9
Other^a	50	96	42	8	47	27	270	20.0
Psychologist^b	–	–	–	–	2	1	3	0.2
Pharmacist^b	–	–	–	–	9	5	14	1.0
Pain specialist^b	–	–	–	–	2	1	3	0.2
	152	358	172	170	223	274	1349

^aOther also includes medical assistants, psychosocial workers and industry professionals.

^b Breakdown of “Other” unavailable for 2011, 2012, 2013 and 2015, which included pharmacists, pain specialists and psychologists.

Table 2. Level of participant agreement for individualising treatment.

Commitment to change	Year	Agreement (%)
Treatments should be individualised by adapting interventions according to treatment response and patient goals	2013	90
Medication should be individualised and guided by assessment and review	2013	91
Individualise treatment planning and delivery including pharmaceutical and non-pharmaceutical therapies	2015	98
Individualise treatment planning and delivery, including pharmaceutical and non-pharmaceutical therapies	2016	97

Table 3. Level of participant agreement for reviewing and optimising treatment.

Commitment to change	Year	Agreement (%)
Monitor/assess therapeutic dosing of maintenance medication based on clinical response	2011	96
Periodically review each patient’s treatment	2011	100
Clinicians should be skilled at selecting and transitioning between treatments	2013	88
Review available MATs; where possible, increase selection offered to my patients	2016	92
Adjust MAT doses according to patients’ clinical signs, symptoms and personal feedback	2017	99

Table 4. Level of participant agreement for providing psychosocial care.

Commitment to change	Year	Agreement (%)
Ensure case management and psychosocial interventions alongside opioid pharmacotherapy	2011	97
Introduce or scale up: use of contingency management	2015	83
Introduce or scale up: use of cognitive behavioural therapy (CBT) in routine clinical practice	2015	84
Explore CBT with relevant patients	2016	83
Introduce or scale up positive rewards to reinforce positive behaviours	2016	70
Introduce or scale up provision of psychosocial therapies such as CBT	2016	97
Incorporate psychosocial therapies in the treatment plans of all of my opioid-dependent patients	2017	97
Motivate all of my opioid-dependent patients to actively participate in psychosocial therapies	2017	98