Nurse-led intervention to decrease drug use among LTBI positive homeless adults.

No randomization or concurrent control group was used, so changes over time cannot be attributed to the intervention. The sample was small (50 enrolled) and mostly male and older, so results may not apply to women or younger homeless adults. Eighty screened persons did not return for results, so participants may have been more ready to engage. Drug use was measured only at baseline, 3 months, and 6 months, and urine tests detect use only in the recent 1 to 3 days. Other services or interventions participants may have received were not controlled for. Self-reported psychosocial data could be affected by recall or social-desirability bias, and urinalysis verified drug use but not alcohol use. Opioid or heroin use could not be assessed separately because only 4 participants reported use at baseline. Problematic alcohol use did not decrease, and cocaine use did not change significantly.

The supplied text does not include a conflict-of-interest declaration. The article is tagged as NIH extramural research support.

Do not conclude that the nurse-led program caused reduced drug use. This was a single-arm pilot with no concurrent control, and participants received TB medication, weekly case management, education, referrals, and missed-dose tracking together, so the contribution of any single component cannot be separated.