title: Respiratory health screening for opiate misusers in a specialist community clinic: a mixed-methods pilot study, with integrated staff and service user feedback.
abstract: Increased rates of illicit drug inhalation are thought to expose opiate misusers (OMUs) to an enhanced risk of respiratory health problems. This pilot study aimed to determine the feasibility of undertaking respiratory screening of OMUs in a community clinic.
  
  
  
  Single-centre UK community substance misuse clinic.
  
  
  
  All clinic attendees receiving treatment for opiate misuse were eligible to participate. 36 participants (mean age=37) were recruited over a 5-week period. The sample included 26 males and 10 females.
  
  
  
  Spirometry without bronchodilation; health related quality of life EQ-5D-3L; Asthma Control Test; Mini Asthma Quality of Life; Clinical COPD Questionnaire and the Treatment Outcome Profile were used to assess the respiratory health of participants. Findings were discussed with staff and service users in 2 patient and public involvement events and feedback was analysed thematically.
  
  
  
  34 participants reported that they had smoked heroin. 8 participants diagnosed with asthma, scored under 13 on the Asthma Control Test, suggesting poorly controlled asthma. Participants (n=28), without a diagnosis of asthma completed the Lung Function Questionnaire. Of these, 79% produced scores under 18, indicating symptoms associated with the development of chronic obstructive pulmonary disease. Spirometry showed 14% of all participants had forced expiratory volume in 1 s/forced vital capacity <0.7 (without bronchodilator), indicating potential obstructive lung disease. Feedback from service users and staff suggested a willingness and capacity to deliver respiratory health screening programmes. Insight towards the difficulties service users have in accessing services and the burden of respiratory health was also provided.
  
  
  
  It is feasible to undertake respiratory health screening of OMUs in a community clinic. Larger screening studies are warranted to determine the prevalence of respiratory health problems in this population. Research regarding asthma medicines adherence and access to healthcare among OMUs is also required.
authors.affiliation: Academic Unit of Primary Care, The University of Sheffield, Sheffield, UK.
authors.forename: Caroline Anne
authors.initials: CA
authors.lastname: Mitchell
authors.affiliation: Academic Unit of Primary Care, The University of Sheffield, Sheffield, UK.
authors.forename: Alice
authors.initials: A
authors.lastname: Pitt
authors.affiliation: School of Health and Related Research, The University of Sheffield, Sheffield, UK.
authors.forename: Joe
authors.initials: J
authors.lastname: Hulin
authors.affiliation: Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
authors.forename: Rod
authors.initials: R
authors.lastname: Lawson
authors.affiliation: Barnsley NHS Trust/Phoenix Futures, Wakefield, UK.
authors.forename: Fleur
authors.initials: F
authors.lastname: Ashby
authors.affiliation: Barnsley NHS Trust/Phoenix Futures, Wakefield, UK.
authors.forename: Ivan
authors.initials: I
authors.lastname: Appelqvist
authors.affiliation: Academic Unit of Primary Care, The University of Sheffield, Sheffield, UK.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Delaney
mesh_terms: D000328:Adult; D001249:Asthma / Q000175:diagnosis*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D053610:Opiate Alkaloids / Q000008:administration & dosage / Q000009:adverse effects*; D010865:Pilot Projects; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis*; D011788:Quality of Life; D012129:Respiratory Function Tests / Q000706:statistics & numerical data*; D057566:Self Report; D019966:Substance-Related Disorders / Q000150:complications*; D006113:United Kingdom; D055815:Young Adult
chemical_list: D053610:Opiate Alkaloids
keywords: Chronic Obstructive Pulmonary Disease; Opiate Addiction; Substance Abuse