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The first national clinical research priority setting study in the AoD sector in Australia

Dr Krista Siefried, Clinical Research Lead and Deputy Director of the National Centre for Clinical Research on Emerging Drugs (NCCRED)
image - Krista Siefried

The first national clinical research priority setting study in the AOD sector in Australia was conducted to determine the focus of clinical research, seed funding, and training programs for The National Centre for Clinical Research on Emerging Drugs (NCCRED).

In response to increasing concern about the personal, family, and community harms arising from methamphetamine use, the Australian government funded the National Ice Action Strategy. NCCRED was funded through the Strategy, and commenced in 2018, to build clinical research capacity and work towards establishing evidence-based treatment approaches for both methamphetamines and other emerging drugs of concern.

Why do a clinical research priority setting study?

In keeping with the NCCRED priority of collaboration, we aimed to use an inclusive approach to drive the research agenda, and undertook a national clinical research priority setting study.

Broadly, health research priority setting aims to select priorities that will have the largest benefit to populations, reduce duplication of research efforts, and promote collaboration. There has been a shift towards more transparent and reproducible methods. There is no ‘gold standard’ approach to priority setting, and our methods drew on the nine common themes of good practice for health research priority setting.

What NCCRED’s study looked like

People with lived experience were involved at each of the four study phases:

  1. An online survey; available from February – March 2019. Forty-seven respondents completed the survey, including people identifying as one or more of: researcher; clinician; family/friend/care-giver of someone who uses methamphetamine / emerging drugs and consumer of methamphetamine / emerging drugs
  2. A thematic analysis of responses
  3. A rapid literature review
  4. An expert panel ranking of priorities, consisting of 12 independent cross-disciplinary stakeholders who volunteered their time

The clinical research priorities identified through this process were:

For methamphetamine clinical research:

  • Overcoming barriers to intervention uptake (e.g. at time of crisis in an emergency department or primary care)
  • Pilot studies of medication(s) to assist people seeking to reduce their methamphetamine use
  • Effective communication strategies to consumers on available treatment and evidence-based options

For emerging drugs of concern clinical research:

  • Fixed-site community located drug checking / “pill testing” – connected to an early warning system
  • Feasibility of social media and other creative opportunities to alert consumers and reduce harm
  • GHB overdose and withdrawal management
  • Early warning system/shared information system (pooling and sharing of information – with consumers and amongst stakeholders throughout Australia) and its impact on reducing harms

Outcomes from the study

NCCRED has adopted these priorities into the programmatic outputs of the Centre across the NCCRED clinical research studies; clinical research seed funding grants; clinical research fellowships and scholarships programs.

Our clinical research addresses these priorities by: a trial of lisdexamfetamine for acute methamphetamine withdrawal; a study examining GHB overdose amongst LGBTQ Australians; and a smartphone application for managing methamphetamine use

NCCRED funded 24 clinical research projects addressing these priorities. These comprise innovative treatment approaches for methamphetamine use disorder, including clinical trials examining: a pharmacotherapy (medication) (n=4); a psychosocial therapy (‘talk’ therapy) (n=6); and transcranial magnetic stimulation (n=1). Our clinical research seed funding program has led to national partnerships, including the Emerging Drugs Network of Australia (EDNA), which provides an early detection network, and is among nine of the funded projects that directly feed into the NCCRED Prompt Response Network (PRN).

Three Clinical Research Fellows have concluded projects, including on telehealth interventions for methamphetamine use disorder; a clinical trial of ketamine for simulant use disorders in youth; and the EDNA project. Furthermore, two NCCRED Clinical Research Scholars commenced in 2021.

In keeping with the clinical research priority setting study’s aim to detail the priority setting process and results transparently, the study has been published, and programmatic outputs have been showcased by the NCCRED clinical research symposia. Two symposiums have been held, and presentations and slides are available publicly on the NCCRED website.

NCCRED demonstrated the potential of using a collaborative approach, and engaging with stakeholders at every stage of the process. This maximises the likelihood that future research findings will be translated to clinical practice and align with consumer experience. We used the results of the priority setting study to inform the direction of NCCRED. In reporting these findings, we hope the valuable insights, that reflect community concerns, will be taken into account when developing future research priorities in the Australian alcohol and other drug sector.