Compliance with aftercare treatment, including disulfiram, and effect on outcome in alcohol-dependent patients.
OBJECTIVE
To delineate the features of treatment compliance which predicted outcome during aftercare treatment in a series of patients that completed an inpatient program at the Lisbon Regional Alcohology Centre (CRAS).


METHODS
Seventy-four alcohol dependent patients, sequentially admitted to the inpatient treatment of CRAS, were followed over 6 months after discharge. This study focused on the predictive value of the aftercare therapies, which included: attending Alcoholics Anonymous (AA) meetings, attending aftercare groups (AG), attending outpatient consultations with the medical assistant. Disulfiram was prescribed to 83.3% of the patients. At the end of the 6-months follow-up period, the patients and their 'significant others' (co-responsible persons) were interviewed on the telephone by an independent interviewer. The data collected for analysis consists of information from the interviews, and also of data from the patient clinical files.


RESULTS
Survival analysis revealed that, after 6 months of follow-up, 39.2% of the patients had attained total abstinence of alcohol ingestion; 71% of the relapses on alcohol consumption occurred within the first 3 months. The median number of days taking disulfiram was significantly related to the number of days of abstinence. Demographic variables, pre-treatment variables, attendance at AA meetings, AGs and outpatient appointments were not significant predictors of outcome.


CONCLUSIONS
Consistently taking disulfiram is associated with good outcome, but this may reflect commitment to abstinence as well as a treatment effect.
Neto
Domingos
D
Centro Regional de Alcoologia do Sul, CRAS, Parque de Saúde de Lisboa, Av. do Brasil, 53 A. 1749-006 Lisbon, Portugal. dneto@mail.telepac.pt
Lambaz
Rita
R
Tavares
João Eduardo
JE
D000328:Adult; D000359:Aftercare / Q000523:psychology* / Q000639:trends; D000427:Alcohol Deterrents / Q000627:therapeutic use*; D000437:Alcoholism / Q000188:drug therapy* / Q000453:epidemiology* / Q000628:therapy; D004221:Disulfiram / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011174:Portugal / Q000453:epidemiology; D055502:Secondary Prevention; D016320:Substance Abuse Treatment Centers / Q000639:trends; D013695:Temperance / Q000639:trends; D016896:Treatment Outcome
D000427:Alcohol Deterrents; D004221:Disulfiram