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Assessing the Feasibility of a Behavioural Intervention for Opioid Reduction (BIOR) in primary care.


Faculty of Health

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Dr Helen Poole , Dr C Montgomery No more applications being accepted Funded PhD Project (UK Students Only)

About the Project

The School of Psychology in the Faculty of Health at Liverpool John Moores University (https://www.ljmu.ac.uk/about-us/faculties/faculty-of-health/school-of-psychology) is offering one 3-year Ph.D. full time, fully funded studentship to undertake research to assess the feasibility of a Behavioural Intervention for reducing harmful opioid use in primary care.

 Background:

The prevalence of chronic non-cancer pain (CNCP) is estimated at between 30-50% in UK adults, with 10.4 - 14.3% reporting severe, life-limiting pain. Alongside, a continuous, significant increase of opioid prescribing has been observed, with the prescribing of strong opioids increasing more than that of weak opioids. Opioid prescribing has increased, despite a lack of convincing evidence for their effectiveness in CNCP, which can result in adverse consequences such as sedation, depression and impaired cognition. A recent UK cohort study found an increased risk of major trauma, overdose and addiction with long-term opioid prescribing, increasing in those on daily doses above 50mg Morphine Equivalent Dose (MED). While studies have established daily doses which could increase harm, there is a lack of guidance on supporting patients in primary care to reduce or stop high dose opioids. Feasibility trials of interventions that support weaning in CNCP are warranted. 

The supervisory team have developed recommendations for a Behavioural Intervention for Opioid Reduction (BIOR), informed by MRC guidance (2008) for the development of complex interventions. These data, relevant literature, and clinical experience allowed us to develop recommendations for an intervention using the COM-B model and Behaviour Change Wheel (BCW). We are now seeking a PhD student to implement and test the feasibility of BIOR in clinical practice.

This PhD studentship will further develop and determine the suitability of a behavioural intervention to support opioid reduction (BIOR) in a primary care setting. This would be an ideal opportunity for a trainee health psychologist with an interest in pain wishing to complete Stage 2 training. The supervisory team has complementary expertise in pain management and health psychology (Helen Poole), substance dependence (Cathy Montgomery) and Pain Medicine (Bernhard Frank) The student will benefit from the multidisciplinary expertise of supervisors/advisors, as well as the training/support opportunities provided by cross Faculty/Institutional working.

This is an exciting and important area of work, with relevance for practice and policy. This is multidisciplinary research and presents opportunities to collaborate with professionals and partners outside of University settings. It is likely to appeal to students from a broad range of disciplines, including, but not limited to health psychology, public health and health sciences. In particular, the position would be ideal for a stage 2 trainee health psychologist who could work towards their accreditation during the project.

Skills required:

We are seeking a highly motivated student, who also has personal skills that are conducive to accessing and conducting research with patient groups and service providers (with the support of the supervisory team).

Applicants must hold a first or upper-second class undergraduate, or a Master’s, degree in psychology or a related discipline. The successful applicant should have a general understanding of quantitative and qualitative methods, and preferably experience of/interest in conducting research in primary care. An excellent standard of verbal and written English is essential as the successful student will be expected to publish from their PhD studies, contribute to relevant publications from the supervisory team as a co-author, and work towards presenting their findings in relevant fora.

The student will be required to develop the exact programme of work, but a mixed methods approach would be most appropriate. Suggested linked-studies include:

·        Study 1 finalise the resources to be used in the BIOR; building on our previous recommendations, relevant literature and relevant clinical guidelines. Production of toolkit and training materials in a range of media to support patients with CNCP to taper and reduce their opioid use. Liaison with the CCG and GP surgeries to train the AHPs who will be local champions involved in delivering BIOR (with support from the supervisory team).

·        Study 2 will test the feasibility, implementation and potential effectiveness of the BIOR intervention delivered in clinical practice. It comprises a mixed design with treatment group (2 levels: Taper vs. Taper with support) as the between groups independent variable and time-point as the within groups independent variable. The dependent variables will be the subjective measures of pain, withdrawal, current MED and pain related questionnaires.

·        Study 3 will be a qualitative process evaluation incorporating semi-structured interviews with a sub-sample of patients exiting the study and AHPs delivering the intervention. The in-depth, semi-structured interviews will be carried out by telephone or virtually to capture patient views on the acceptability and feasibility of the intervention, their experiences tapering and supported self-management and any perceived effects on pain and quality of life. AHPs interviews will elicit their views on intervention training and implementation. 

Supervision:

Dr Helen Poole is the Director of studies (https://www.ljmu.ac.uk/about-us/staff-profiles/faculty-of-health/school-of-psychology/helen-poole) and the project will be co-supervised by Dr Cathy Montgomery (https://www.ljmu.ac.uk/about-us/staff-profiles/faculty-of-health/school-of-psychology/cathy-montgomery) and Dr Bernhard Frank, Consultant in Pain Medicine at The Walton Centre, Liverpool (https://www.thewaltoncentre.nhs.uk/Consultant/8/Dr-Bernhard-Frank.html)

For an informal discussion contact Dr Helen Poole [Email Address Removed] or Dr Cathy Montgomery [Email Address Removed] 

To apply:

Please submit by email your CV and a cover letter explaining your interests and skills relating to this opportunity to Helen Poole [Email Address Removed]    

We are expecting to hold interviews online via zoom/teams w/c 24th May.

 


Funding Notes

Studentship to commence before June 30th 2021.
The studentship includes a tax-free stipend of £15285 p.a. and the tuition fees for UK students only for three years. An additional £1,500 p.a. will be available for research costs. The student will initially formally register for the award within 3 months of enrolment and will be expected to transfer to PhD registration within 12 months (subject to satisfactory progress and approval of the transfer report).


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