title: Assertive Community Treatment For People With Alcohol Dependence: A Pilot Randomized Controlled Trial.
abstract: OBJECTIVE
  A pilot randomized controlled trial (RCT) to assess the feasibility and potential efficacy of assertive community treatment (ACT) in adults with alcohol dependence.
  
  
  METHODS
  Single blind, individually randomized, pilot RCT of 12 months of ACT plus treatment as usual (TAU) versus TAU alone in adults (age 18+ years) with alcohol dependence and a history of previous unsuccessful alcohol treatment attending specialist community alcohol treatment services. ACT aimed to actively engage participants for 12 months with assertive, regular, minimum weekly contact. ACT was combined with TAU. TAU comprised access to the full range of services provided by the community teams. Primary outcome is mean drinks per drinking day and percent days abstinent at 12 months follow up. Analysis of covariance was conducted using 80% confidence intervals, appropriate in the context of a pilot trial.
  
  
  RESULTS
  A total of 94 participants were randomized, 45 in ACT and 49 in TAU. Follow-up was achieved with 98 and 88%, respectively at 12 months. Those in ACT had better treatment engagement, and were more often seen in their homes or local community than TAU participants. At 12 months the ACT group had more problems related to drinking and lower quality of life than TAU but no differences in drinking measures. The ACT group had a higher percentage of days abstinent but lower quality of life at 6 months. The ACT group had less unplanned healthcare use than TAU.
  
  
  CONCLUSIONS
  An trial of ACT was feasible to implement in an alcohol dependent treatment population.
  
  
  BACKGROUND
  ISRCTN22775534.
authors.affiliation: Addictions Department, National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 4 Windsor Walk, LondonSE5 8BB, UK.
authors.forename: Colin
authors.initials: C
authors.lastname: Drummond
authors.affiliation: Addictions Department, National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 4 Windsor Walk, London SE5 8BB, UK.|King's Fund, 11 Cavendish Square, London W1G 0AN, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Gilburt
authors.affiliation: Department of Psychiatry, Warneford Hospital, University of Oxford, OxfordOX3 7JZ, UK.
authors.forename: Tom
authors.initials: T
authors.lastname: Burns
authors.affiliation: School of Psychology, University of Birmingham, Edgbaston, BirminghamB15 2TT, UK.
authors.forename: Alex
authors.initials: A
authors.lastname: Copello
authors.affiliation: Center for Mental Health, Imperial College London, Commonwealth Building, Hammersmith Campus, Du Cane Road, LondonW12 0NN, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Crawford
authors.affiliation: Addictions Department, National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 4 Windsor Walk, LondonSE5 8BB, UK.
authors.forename: Ed
authors.initials: E
authors.lastname: Day
authors.affiliation: Addictions Department, National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 4 Windsor Walk, LondonSE5 8BB, UK.
authors.forename: Paolo
authors.initials: P
authors.lastname: Deluca
authors.affiliation: Department of Health Sciences, University of York, Seebohm Rowntree Building, University of York, Heslington, YorkYO10 5DD, UK.
authors.forename: Christine
authors.initials: C
authors.lastname: Godfrey
authors.affiliation: Department of Health Sciences, University of York, Seebohm Rowntree Building, University of York, Heslington, YorkYO10 5DD, UK.
authors.forename: Steve
authors.initials: S
authors.lastname: Parrott
authors.affiliation: Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Waterhouse Building, LiverpoolL69 3BX, UK.
authors.forename: Abigail
authors.initials: A
authors.lastname: Rose
authors.affiliation: Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, University Road, SouthamptonSO17 1BJ, UK.
authors.forename: Julia
authors.initials: J
authors.lastname: Sinclair
authors.affiliation: Centre for Health Services Studies, George Allen Wing, Cornwallis Building, University of Kent, Canterbury, KentCT2 7NF, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Coulton
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000628:therapy*; D003156:Community Mental Health Services; D005260:Female; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care; D010865:Pilot Projects; D016037:Single-Blind Method; D055815:Young Adult