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Adjunctive Medication Management and Contingency Management to enhance adherence to acamprosate for alcohol
Kim Donoghue1,2, Sadie Boniface2,3, Eileen Brobbin2
1Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.
Contingency Management combined with Medication Management significantly improved adherence to acamprosate, an effective medication for alcohol relapse prevention. This combined approach was also found to be cost-effective, offering a promising strategy to enhance treatment benefits.
Area of Science:
- Clinical Medicine
- Psychiatry
- Health Economics
Background:
- Acamprosate is a cost-effective medication for preventing alcohol relapse.
- Poor adherence to acamprosate can limit its effectiveness.
- Interventions to improve acamprosate adherence are needed.
Purpose of the Study:
- To evaluate the effectiveness of Medication Management (MM) with and without Contingency Management (CM) compared to Standard Support (SS) alone.
- To assess the impact of acamprosate adherence on abstinence and reduced alcohol consumption.
Main Methods:
- A multicentre, three-arm, parallel-group, randomised controlled trial.
- Adults diagnosed with alcohol dependence, abstinent at baseline, and prescribed acamprosate were included.
- Interventions: SS alone, SS + MM (12 sessions over 6 months), SS + MM + CM (vouchers up to £120).
Main Results:
- Adherence to acamprosate was significantly higher in the SS + MM + CM group compared to SS alone (10.6% difference).
- No significant difference in adherence was found between SS + MM and SS alone.
- The SS + MM + CM approach was cost-effective, improving quality-adjusted life-years at a lower cost.
Conclusions:
- Medication Management enhanced with Contingency Management is beneficial for improving patient adherence to acamprosate.
- Future research should explore the effectiveness and cost-effectiveness of CM with other interventions for alcohol use disorder.
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