Factors influencing adherence to anti-craving medications and drinking outcomes in patients with alcohol dependence: A hospital-based study

K, Lohit; Kulkarni, Chanda; Galgali, R B

doi:10.4103/0976-500x.184770

Cited by 14 publications

(11 citation statements)

References 14 publications

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“…The percentage of patients who were adherent in each group was exceptionally high for an alcohol pharmacotherapy trial. Depending on the definition of medication adherence, rates of medication adherence range from a low of 20% to a high of 80% (Lohit, 2016); results of the current study show a medication adherence rate of over 90%.…”

Section: Discussionmentioning

confidence: 70%

The clinical utility of the Medication Adherence Questionnaire (MAQ) in an alcohol pharmacotherapy trial

Zweben

Piepmeier

Fucito

et al. 2017

Journal of Substance Abuse Treatment

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Background Medication nonadherence is a ubiquitous problem in pharmacology treatment for alcohol use disorders. Unintentional and purposeful nonadherence as measured by the Medication Adherence Questionnaire (MAQ) has been shown to predict problems with medication adherence; however, feedback from the MAQ has never been incorporated into a behavioral intervention to facilitate medication adherence. We assessed the integration of the MAQ into Medical Management (MM), a counseling approach frequently employed in conjunction with alcohol pharmacotherapy, to determine whether prior patterns of nonadherence could be addressed effectively to promote medication adherence. Methods We conducted a post-hoc analysis of data from 131 alcohol dependent smokers who participated in a double blind, placebo controlled study of varenicline for the treatment of alcohol dependence. At baseline, participants completed a single administration of the MAQ, which asks 2 questions about unintentional nonadherence (e.g., forgetting) and 2 questions about purposeful nonadherence (e.g., stopping because feeling good or feeling bad). Based on these responses, participants were divided into 1 of 3 three categories. Adherent (n=60), Unintentional or Purposeful Nonadherent (n=50) and Unintentional and Purposeful Nonadherent (n=21). Over the course of the 16-week treatment period, patients were expected to participate in 12 Medical Management (MM) sessions; a brief psychosocial treatment. Feedback based on the MAQ responses was integrated into the MM sessions to facilitate medication and treatment adherence. Results The 3 adherence groups were compared on baseline characteristics, medication adherence, treatment attendance and end-of-treatment patient ratings of treatment helpfulness. Baseline demographics and characteristics were not significantly different among the three categories. We found no statistically significant differences among the three groups with respect to pill adherence, treatment attendance, and treatment satisfaction ratings. Conclusions The findings suggest that the incorporation of MAQ feedback into the MM approach could be effective in mitigating risks associated with prior patterns of nonadherence suggesting that further testing of the integrated behavioral approach is warranted.

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Section: Discussionmentioning

confidence: 70%

The clinical utility of the Medication Adherence Questionnaire (MAQ) in an alcohol pharmacotherapy trial

Zweben

Piepmeier

Fucito

et al. 2017

Journal of Substance Abuse Treatment

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“…[3132] A recent study reported that decrease in adherence to acamprosate and naltrexone was associated with significantly higher relapse rate and decreased abstinence. [33] There have been controversial findings regarding lack of efficacy of acamprosate and naltrexone. One retrospective chart review from India found no significant difference in abstinence rates between the patients receiving acamprosate and naltrexone.…”

Section: Discussionmentioning

confidence: 99%

“…First, lack of randomized controlled trials with blinding is of the most important methodological flaws. The studies have largely been cross-sectional as well as prospective-observational studies[72633464748] and retrospective chart reviews. [20214950] There were few randomized open-labeled trials.…”

Section: Discussionmentioning

confidence: 99%

Pharmacotherapy for relapse prevention of alcohol use disorder in the Indian setting: A systematic review

2018

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Alcohol use disorders (AUDs) is an important public health concern as estimates of the prevalence of AUD range at 4%–6% in the Indian population. Currently, there is limited literature on the pharmacotherapeutic interventions for AUD in the Indian setting. It is imperative to identify the possible variations in their effects from Western studies, and hence the current review was attempted to perform a comprehensive evaluation and critical appraisal of the methodology of the evidence on pharmacological strategies of relapse prevention of AUD in the Indian setting. A total of 18 studies were included in the review. Disulfiram was the most common pharmacological agent to be studied. The initial literature before 2000 focused primarily on disulfiram, whereas the studies in the next decade compared it to acamprosate and naltrexone and emerging interest in anticraving agents such as baclofen and topiramate had been noted over the past few years. No studies were available on newer agents such as ondansetron, selective serotonin reuptake inhibitors or formulations such as depot and implants. Deterrent agents were found to be better when compared to anticraving agents in terms of abstinence and relapse, whereas the latter were more effective for control of craving. Among the pharmacological agents studied, the greatest evidence exists for disulfiram for relapse prevention which could be due to affordability of disulfiram and social support in the Indian context. The chief methodological limitations include the lack of randomized trials and objective measures for assessing abstinence.

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“…50 Despite the above, XR-NTX in a primary care setting has significantly shown to be more effective, feasible, and cost-effective than O-NTX. 51 Furthermore, for patients with comorbid opioid misuse who are in treatment for AUD, XR-NTX could enhance treatment adherence. 27 Barriers to adherence in people with AUD included younger age, self-decision, emotional factors, adverse events greater drinking severity, dissatisfaction with the treatment and session frequency and lack of perceived benefit.…”

Section: Adherence and Predictorsmentioning

confidence: 99%

Monitoring and Improving Naltrexone Adherence in Patients with Substance Use Disorder

Pérez-Maciá¹,

Cortes²,

Mesones³

et al. 2021

PPA

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Objective: Naltrexone is an opioid antagonist used for the treatment of patients with opioid use disorder and alcohol use disorder. This population often presents problems of follow-up and therapeutic efficacy related to adherence to treatment. The purpose of our study is to provide an exhaustive summary of the current evidence regarding naltrexone adherence in people with substance use disorders and to identify possible variables that may influence adherence to naltrexone. Methods: Two searches were performed in bibliographic databases (PubMed, Embase), and studies included in the systematic review were those published from January 1, 2011 to September 2020, with participants over 18 years of age, evaluating treatment with naltrexone in alcohol use disorder and opioid use disorder. From the total of 133 articles initially selected, 36 were included and analyzed in the systematic review. Results: Naltrexone has not demonstrated superiority over other available treatments in terms of adherence and abstinence, although reinforcement systems have obtained favorable results as an additional strategy to improve adherence. Conclusion:It is necessary to study other psychosocial variables involved in improving adherence, in addition to taking patient preferences into account in order to improve the external validity of the results.

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Factors influencing adherence to anti-craving medications and drinking outcomes in patients with alcohol dependence: A hospital-based study

Cited by 14 publications

References 14 publications

The clinical utility of the Medication Adherence Questionnaire (MAQ) in an alcohol pharmacotherapy trial

The clinical utility of the Medication Adherence Questionnaire (MAQ) in an alcohol pharmacotherapy trial

Pharmacotherapy for relapse prevention of alcohol use disorder in the Indian setting: A systematic review

Monitoring and Improving Naltrexone Adherence in Patients with Substance Use Disorder

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