title: Treatment expectations and satisfaction of treatment-refractory opioid-dependent patients in RIOTT, the Randomised Injectable Opiate Treatment Trial, the UK's first supervised injectable maintenance clinics.
abstract: OBJECTIVE
  The study investigates patients' pre-treatment expectations of, and post-treatment satisfaction with, supervised injectable opiate treatment delivered within UK's first such clinics within the Randomised Injectable Opiate Treatment Trial (RIOTT) (ISRCTN0133807).
  
  
  METHODS
  Data were collected from 127 chronic heroin addicts recruited to RIOTT and randomised to receive supervised injectable (heroin or methadone) treatment or optimised oral maintenance treatment at supervised injectable maintenance clinics in London, Darlington and Brighton.
  
  
  RESULTS
  Of 127 RIOTT patients, 113 (89%) provided responses to structured enquiry about treatment expectations, and 94 (74%) subsequent responses about treatment satisfaction (at six months). Patients were hoping that injectable heroin treatment would: reduce substance misuse (81%); help achieve normality, routine and structure (16%); and increase education and work prospects (15%). At six months, an area of treatment satisfaction most commonly reported by all three trial groups was reduced substance misuse (supervised injectable heroin 59%, supervised injectable methadone 56%, optimised oral methadone 54%). Most found supervision acceptable, but some desired modifications were also identified.
  
  
  CONCLUSIONS
  Patients previously considered non-responsive to treatment appear to have similar treatment expectations and aspirations as other drug users in treatment. Supervised injectable opioid treatment patients consistently reported treatment satisfaction but also that more could be done to optimise aspects of current arrangement. This raised the challenging issue of the extent to which opinions of patients need to be taken into consideration in shaping future treatment provision. Future research may need to examine the extent of expectations 'fit' and the relationship between treatment sought and received.
authors.affiliation: National Addiction Centre, King's College London, London, UK; European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal.
authors.forename: Teodora
authors.initials: T
authors.lastname: Groshkova
authors.forename: Nicola
authors.initials: N
authors.lastname: Metrebian
authors.forename: Christopher
authors.initials: C
authors.lastname: Hallam
authors.forename: Vikki
authors.initials: V
authors.lastname: Charles
authors.forename: Anthea
authors.initials: A
authors.lastname: Martin
authors.forename: Luciana
authors.initials: L
authors.lastname: Forzisi
authors.forename: Nicholas
authors.initials: N
authors.lastname: Lintzeris
authors.forename: John
authors.initials: J
authors.lastname: Strang
mesh_terms: D000284:Administration, Oral; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D003932:Heroin / Q000008:administration & dosage*; D006556:Heroin Dependence / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D007267:Injections; D008297:Male; D008691:Methadone / Q000008:administration & dosage*; D008875:Middle Aged; D018671:Needle-Exchange Programs; D017060:Patient Satisfaction; D016896:Treatment Outcome; D006113:United Kingdom
chemical_list: D003932:Heroin; D008691:Methadone
keywords: expectation; supervised injectable opiate treatment; treatment satisfaction