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Does assertive community treatment increase medication adherence for people with co-occurring psychotic and substance
Jennifer I Manuel1, Nancy H Covell, Carlos T Jackson
1Department of Psychiatry, College of Physicians and Surgeons, Columbia University and New York State Psychiatric Institute, New York, NY 10032, USA. jm703@columbia.edu
Objective:
This study analyzed data from a randomized trial to examine the impact on medication adherence of integrated treatment delivered via assertive community treatment (ACT) versus standard clinical case management (SCCM).
Method:
Data from the original study included 198 study participants with co-occurring psychotic and substance use disorders who were randomly assigned to receive integrated treatment via ACT or SCCM and were followed for 3 years. We applied mixed-effects logistic regression to estimate group (ACT vs. SCCM) by time effects on a self-report measure of medication adherence. Adherence was dichotomized as 20% or more missed medication days ("poor adherence") versus less than 20% missed medication days ("adequate adherence").
Results:
Participants who were assigned to ACT reported significant improvement in medication adherence compared with those assigned to SCCM.
Conclusions:
Integrated treatment delivered via ACT may benefit persons with co-occurring psychotic and substance use disorders who are poorly adherent to medications.
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