Developing and piloting a self-management program for substance addiction consequences

BackGound: To create a program for self-management of the substance addiction consequences, for people involved in a medication- based programs.

Methods: The Medical Research Council's framework for the Development of Complex Interventions were used. A Scoping review, one focus group with nurses and six interviews with users on a medication-based program were carried out (lexicographical textual analysis were used), during 2021. Those contributions allowed intervention design that will be submitted to a experts panel through a modified e-Delphy.

Results: Ten scoped programs were group interventions and eight individual approaches. The most common used was motivational strategies, relapse prevention, help users to identify and define active plans for risky situations. Active therapeutic interventions and commitment of health professionals benefit patients’ health and consequences self-management.

From interviews, nurses recognize the need to change the intervention paradigm with a more structured approach centered on people's needs and flexible. Users add the need to be flexible, with no set time at the outset and focused on basic needs, such as having a job, therapeutic support for abstinence and managing comorbidities. Both, agree on the need for the program.

Severity indicators related to substance addiction consequences were identified and collected from programs in the literature, and with nurses and users perceptions. The elected thematic areas for the program are related to: The problematic use of substances; Health knowledge in general; Health-seeking behavior and adherence; Self-knowledge and well-being; Social role and personal dignity; Family support. Structurally, with temporal flexibility, with a minimum of 8 sessions and interactions up to 60 min. Mixed individual and group interventions.

Conclusions: The program design determined areas of multifactorial attention to be dealt with by users. They require motivational, psychoeducational, cognitive-behavioural, and psychotherapeutic strategies. A program with this design will be submitted to expert consensus. After that, it can be tested in different contexts.