title: Factors influencing adherence to anti-craving medications and drinking outcomes in patients with alcohol dependence: A hospital-based study.
abstract: OBJECTIVE
  To examine the factors influencing the pattern and extent of anti-craving medication adherence and drinking outcomes in alcohol-dependent patients.
  
  
  METHODS
  Demographic data from 102 inpatients were collected at discharge from hospital. The pattern of anti-craving medication, extent of adherence, and drinking outcome was collected at 1(st), 3(rd), 8(th), and 12(th) week follow-up. Patients' self-reported adherence, medication diary, and simplified medication adherence questionnaire were used and data were analyzed using SPSS.
  
  
  RESULTS
  Majority (99%) were male patients with a mean age of 41.17 ± 9.86 years and 70% belonged to middle socioeconomic status. There was a decrease in the number of patients coming for follow-up over time from 99.01% to 77.45% on day 90. Acamprosate was used in 74% and naltrexone and disulfiram in 7% of patients each. A significant reduction in adherence to acamprosate and naltrexone (P < 0.001) was associated with simultaneous decrease in days to alcohol abstinence and increase in relapse rate compared to adherent group (P < 0.001). Main barriers to adherence included younger age (odds ratio = 1.05 95% [1.01-1.09]; P < 0.01), self-decision, emotional factors, and adverse effects.
  
  
  CONCLUSIONS
  The study demonstrated the need for safer therapeutic options along with suitable intervention at grass root level for sustenance of adherence to anti-craving medication among young adults to prevent relapse and achieve near-complete abstinence from alcohol dependence.
authors.affiliation: Department of Pharmacology, Sri Siddhartha Medical College, Tumakuru, Karnataka, India.
authors.forename: K
authors.initials: K
authors.lastname: Lohit
authors.affiliation: Division of Clinical Pharmacology, St. John's Medical College and Hospital, Bengaluru, Karnataka, India.
authors.forename: Chanda
authors.initials: C
authors.lastname: Kulkarni
authors.affiliation: Department of Psychiatry, St. John's Medical College and Hospital, Bengaluru, Karnataka, India.
authors.forename: R B
authors.initials: RB
authors.lastname: Galgali
keywords: Acamprosate; adherence; alcohol dependence; anti-craving medications; drinking outcomes