Reid Sophie C, Teesson Maree, Sannibale Claudia, Matsuda Michiyo, Haber Paul S
Drug Health Services, Royal Prince Alfred Hospital, Missenden Road, Camperdown, New South Wales 2050, Australia.
J Stud Alcohol. 2005 Nov;66(6):833-41. doi: 10.15288/jsa.2005.66.833.
This study sought to evaluate the effectiveness of compliance therapy in increasing adherence to pharmacological treatment for alcohol dependence.
Forty subjects were randomly allocated to receive usual medical care (n = 20) or usual medical care plus compliance therapy (n = 20). All subjects were prescribed acamprosate (Campral) for 4 months. Subjects were volunteers treated at a hospital-based outpatient drug and alcohol treatment service, and were men and women who were 18-65 years old and with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnosis of alcohol dependence. All subjects received usual medical care consisting of seven medical reviews (duration = 15 minutes) over 4 months. Compliance therapy consisted of four to six individual sessions (duration = 60 minutes) in which beliefs about medication side effects, ambivalence, the benefits of treatment, treatment maintenance and relapse prevention were addressed and explored with motivational interviewing and cognitive behavior therapy techniques.
The outcome variables were number of days taking acamprosate, days to first drink, days to first relapse (more than five drinks) and days to first extended relapse (greater than 2 consecutive days of more than five drinks). Intention-to-treat analyses showed little difference between the two groups in the outcome drinking measures. Nevertheless, the per-protocol analyses revealed that participation in three or more sessions of compliance therapy significantly increased adherence to acamprosate and improved overall treatment outcomes.
The present study highlights the need for psychological interventions to improve adherence to pharmacotherapy in the treatment of alcohol dependence and provides initial support for compliance therapy as an effective intervention.
本研究旨在评估依从性治疗在提高酒精依赖药物治疗依从性方面的有效性。
40名受试者被随机分配接受常规医疗护理（n = 20）或常规医疗护理加依从性治疗（n = 20）。所有受试者均被处方服用阿坎酸（坎普拉尔）4个月。受试者为在一家医院门诊药物和酒精治疗服务机构接受治疗的志愿者，年龄在18 - 65岁之间，根据《精神障碍诊断与统计手册》第四版诊断为酒精依赖，包括男性和女性。所有受试者在4个月内接受了由七次医疗复查（每次时长15分钟）组成的常规医疗护理。依从性治疗包括四至六次个体治疗（每次时长60分钟），在治疗中运用动机性访谈和认知行为治疗技术，探讨并处理关于药物副作用、矛盾心理、治疗益处、治疗维持和预防复发的信念。
结果变量包括服用阿坎酸的天数、首次饮酒天数、首次复发（超过五杯酒）天数和首次持续复发（连续两天以上超过五杯酒）天数。意向性分析显示，两组在饮酒相关结果指标上差异不大。然而，符合方案分析表明，参与三次或更多次依从性治疗显著提高了对阿坎酸的依从性，并改善了总体治疗结果。
本研究强调了在酒精依赖治疗中进行心理干预以提高药物治疗依从性的必要性，并为依从性治疗作为一种有效干预措施提供了初步支持。
