Alcohol Dependence and Adherence to Medicine (ADAM)
Research type
Research Study
Full title
A three-arm, Randomised Controlled Trial of the effectiveness and cost-effectiveness of adjunctive medication management and contingency management to enhance adherence to medications for relapse prevention in alcohol dependence
IRAS ID
167511
Contact name
Keith Brennan
Contact email
Sponsor organisation
King's College London
Duration of Study in the UK
3 years, 0 months, 1 days
Research summary
It has been identified that the use of acamprosate improves patient outcomes and is cost-effective. Clinical guidance supports the routine use of acamprosate for people with alcohol dependence to help prevent relapse. Despite acamprosate’s therapeutic value, the medication is often not taken as prescribed, therefore the maximum benefit that could be gained from taking it is not reached in all patients. This study is aimed at improving the adherence to acamprosate to maximise the benefits for patients. We will employ medication management (MM) and contingency management (CM) techniques that have achieved positive outcomes in other studies.
MM is an intervention to help improve medication and treatment adherence by providing education, support and advice to patients about their drinking behaviours and medication. This has been used in several clinical trials but is not consistently delivered as part of routine care in specialist alcohol services in the UK. CM, which involves providing small financial or other incentives to change behaviour and/or engage with treatment, including medication adherence, has been found to be effective in substance misusers but there is currently limited evidence available for alcohol dependence. The current study aims to investigate the effectiveness and cost effectiveness of MM and CM for improving adherence to acamprosate.Participants will be eligible for inclusion if they are aged 18+, alcohol dependent, currently abstinent and starting acamprosate. Potential participants will be identified through community alcohol services at five locations in England. All participants will be randomly allocated to one of three trial arms; standard support (SS), SS plus MM and SS and MM with CM. MM and CM will be administered to participants by via a central telephone support service by trained pharmacists. The MM and CM will be delivered in 12 sessions over 6 months and participants will also be followed up by the research team at 6 and 12 months after randomisation.
REC name
East of England - Cambridge South Research Ethics Committee
REC reference
15/EE/0308
Date of REC Opinion
17 Sep 2015
REC opinion
Further Information Favourable Opinion