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Randomized Controlled Trial
. 2011 Jan-Feb;17(1):51-6.
doi: 10.1177/1078390310395586.

Does assertive community treatment increase medication adherence for people with co-occurring psychotic and substance use disorders?

Jennifer I Manuel  1 , Nancy H Covell, Carlos T Jackson, Susan M Essock
Affiliations
Randomized Controlled Trial

Does assertive community treatment increase medication adherence for people with co-occurring psychotic and substance use disorders?

Jennifer I Manuel et al. J Am Psychiatr Nurses Assoc. 2011 Jan-Feb.

Abstract

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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Figures

Figure 1
Figure 1
Estimated (E) and observed (O) probability values of poor adherence over time and treatment group Note. ACT = assertive community treatment; SCCM = standard clinical case management.
See this image and copyright information in PMC

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