{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T19:09:34Z","timestamp":1790622574182,"version":"4.1.0"},"reference-count":39,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T00:00:00Z","timestamp":1715558400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100011529","name":"Scottish Government Health and Social Care Directorate","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011529","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>In Scotland, a third of all deaths of people experiencing homelessness (PExH) are street-drug-related, and less than half of their multiple physical- and mental health conditions are treated. New, holistic interventions are required to address these health inequalities. PHOENIx (Pharmacist Homeless Outreach Engagement and Non-medical Independent prescribing Rx) is delivered on outreach by National Health Service (NHS) pharmacist independent prescribers in partnership with third sector homelessness charity workers. We describe participant\u2019s perspectives of PHOENIx.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This study aims to understand experiences of the PHOENIx intervention by participants recruited into the active arm of a pilot randomised controlled trial (RCT). Semi-structured in-person interviews explored participants\u2019 evaluation of the intervention. In this study, the four components (<jats:italic>coherence<\/jats:italic>, <jats:italic>cognitive participation<\/jats:italic>, <jats:italic>collective action<\/jats:italic>, <jats:italic>reflexive monitoring<\/jats:italic>) of the Normalisation Process Theory (NPT) framework underpinned data collection and analyses.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>We identified four themes that were interpreted within the NPT framework that describe participant evaluation of the PHOENIx intervention: differentiating the intervention from usual care (<jats:italic>coherence<\/jats:italic>), embedding connection and consistency in practice (<jats:italic>cognitive participation<\/jats:italic>), implementation of practical and emotional operational work (<jats:italic>collective action<\/jats:italic>), and lack of power and a commitment to long-term support (<jats:italic>reflexive monitoring<\/jats:italic>). Participants successfully engaged with the intervention. Facilitators for participant motivation included the relationship-based work created by the PHOENIx team. This included operational work to fulfil both the practical and emotional needs of participants. Barriers included concern regarding power imbalances within the sector, a lack of long-term support and the impact of the intervention concluding.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Findings identify and describe participants\u2019 evaluations of the PHOENIx intervention. NPT is a theoretical framework facilitating understanding of experiences, highlighting both facilitators and barriers to sustained engagement and investment. Our findings inform future developments regarding a subsequent definitive RCT of PHOENIx, despite challenges brought about by challenging micro and macro-economic and political landscapes.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0302988","type":"journal-article","created":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T17:36:24Z","timestamp":1715621784000},"page":"e0302988","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":10,"title":["Perspectives of people experiencing homelessness with recent non-fatal street drug overdose on the Pharmacist and Homeless Outreach Engagement and Non-medical Independent prescribing Rx (PHOENIx) intervention"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3612-4518","authenticated-orcid":true,"given":"Natalia","family":"Farmer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9961-2338","authenticated-orcid":true,"given":"Andrew","family":"McPherson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jim","family":"Thomson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Lowrie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,5,13]]},"reference":[{"key":"pone.0302988.ref001","doi-asserted-by":"crossref","first-page":"e000219","DOI":"10.1136\/bmjph-2023-000219","article-title":"Holistic health and social care outreach for people experiencing homelessness with recent non-fatal overdose in Glasgow, Scotland: the Pharmacist and third sector Homeless charity worker Outreach Engagement Non-medical Independent prescriber Rx (PHOENIx) pilot randomised controlled trial.","volume":"2","author":"R Lowrie","year":"2024","journal-title":"BMJ Public Health"},{"key":"pone.0302988.ref002","doi-asserted-by":"crossref","first-page":"49","DOI":"10.12688\/wellcomeopenres.15151.1","article-title":"Causes of death among homeless people: a population-based cross-sectional study of linked hospitalisation and mortality data in England.","volume":"4","author":"RW Aldridge","year":"2019","journal-title":"Wellcome Open Res."},{"issue":"7","key":"pone.0302988.ref003","article-title":"Outreach-based clinical pharmacist prescribing input into the healthcare of people experiencing homelessness: a qualitative investigation.","volume":"21","author":"S Johnsen","year":"2021","journal-title":"BMC Health Serv Res."},{"issue":"1","key":"pone.0302988.ref004","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/s12939-020-01337-7","article-title":"Pharmacist led homeless outreach engagement and non-medical independent prescribing (Rx) (PHOENIx) intervention for people experiencing homelessness: a non-randomised feasibility study.","volume":"20","author":"R Lowrie","year":"2021","journal-title":"Int J Equity Health"},{"key":"pone.0302988.ref005","volume-title":"Homeless deaths in 2021.","author":"National Records for Scotland","year":"2022"},{"issue":"7","key":"pone.0302988.ref006","doi-asserted-by":"crossref","first-page":"e0254729","DOI":"10.1371\/journal.pone.0254729","article-title":"What treatment and services are effective for people who are homeless and use drugs? 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