Target recruitment was 74 pharmacies. Once consented, pharmacies were randomised independently to intervention or control, by the Health Services Research Unit, University of Aberdeen, Scotland, UK. Participating pharmacists approached all daily supervised methadone patients, initiated in the last 24 months and aged >18 years. Pharmacists recruited patients retrospectively LDE225 mw (from the last 12 patients joining the pharmacy) and prospectively (patients starting methadone over the next 6 months). Patients gave informed written consent. Intervention pharmacists

used MI techniques during interactions with study patients over the 6-month follow-up period. The intervention was intended to be spread over a number of visits, building on discussions during previous interactions. Discussions were to focus on reducing illicit heroin and other drug use. Control pharmacists continued with normal practice. Both pharmacy groups were sent four newsletters during the study period directing them to the study website, which provided study progress information. Newsletters for the intervention group included reminders on MI techniques. Intervention pharmacists were trained in MI techniques, during four sessions provided by Scottish Training on Drugs and Alcohol (STRADA)-accredited MI trainers. Those unable to attend were visited and provided with equivalent self-study materials. Training was based on that

used in the pilot study. MAPK inhibitor Training provided a framework for increased communication as well as specific communication skills (i.e. using open questions, reflective listening, affirming and eliciting BIRB 796 research buy ‘change talk’). The first two sessions emphasised how MI techniques could be used by initiating discussions about their current treatment and drug usage using suggested open questions and standard approaches. It was explained to pharmacists that these

discussions can take place over a number of days, which is the key aspect of pragmatic pharmacist delivered MI; whilst each interaction may also be brief, because they happen on a daily basis, they were regarded as one interaction with ongoing dialogue. The second and third sessions covered the practical application of skills based on pharmacists’ experiences in practice. Pharmacists received resource packs including area-specific information on available services (e.g. needle exchange, counselling, housing support, debt management). Competence in MI techniques was assessed at the final training session using the BECCI.[13] Pharmacists worked in triads, in which each sequentially assumed the role of pharmacist, the patient or observer/assessor who completed the BECCI. These data were reviewed by the trainer present to ensure competency had been achieved. The primary outcome was illicit heroin use. Secondary outcomes were retention in treatment, use of other illicit drugs, physical/psychological health and treatment satisfaction.