ArticleAddictive behaviors2013
Temporal patterns of adherence to medications and behavioral treatment and their relationship to patient characteristics and treatment response.
Article in Addictive behaviors, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The rates and measurement of adherence to acamprosate in randomised controlled clinical trials: A systematic review.PloS one · 2022Pooled it
- Structural analysis of causal pathways between adherence, satisfaction and clinical outcomes in hypertensive patients using a mobile adherence intervention: A SEM-NCA-cIPMA approach.Journal of human hypertension · 2026Trial
- Adjunctive Medication Management and Contingency Management to enhance adherence to acamprosate for alcohol dependence: the ADAM trial RCT.Health technology assessment (Winchester, England) · 2023Trial
- Mechanisms of quality-of-life improvement in treatment for alcohol use disorder.Journal of consulting and clinical psychology · 2022Trial
- The clinical utility of the Medication Adherence Questionnaire (MAQ) in an alcohol pharmacotherapy trial.Journal of substance abuse treatment · 2017Trial
- Predictors of Abstinence From Heavy Drinking During Follow-Up in COMBINE.Journal of studies on alcohol and drugs · 2015Trial
- What happens when people discontinue taking medications? Lessons from COMBINE.Addiction (Abingdon, England) · 2014Trial
- Methods to analyze treatment effects in the presence of missing data for a continuous heavy drinking outcome measure when participants drop out from treatment in alcohol clinical trials.Alcoholism, clinical and experimental research · 2014Trial
- HIV protective efficacy and correlates of tenofovir blood concentrations in a clinical trial of PrEP for HIV prevention.Journal of acquired immune deficiency syndromes (1999) · 2014Trial
- Adherence trajectories and predictors of digital balance exercise for fall prevention in community-living older people.NPJ digital medicine · 2026Article
- GDNF gene therapy for alcohol use disorder in male non-human primates.Nature medicine · 2023Article
- Service Users' Views and Experiences of Alcohol Relapse Prevention Treatment and Adherence: New Role for Pharmacists?Alcohol and alcoholism (Oxford, Oxfordshire) · 2022Article
- African Americans' Hemodialysis Treatment Adherence Data Assessment and Presentation: A Precision-Based Paradigm Shift to Support Quality Improvement Activities.Kidney medicine · 2022Article
- Comparing Continuous and Binary Group-based Trajectory Modeling Using Statin Medication Adherence Data.Medical care · 2021Article
- Monitoring and Improving Naltrexone Adherence in Patients with Substance Use Disorder.Patient preference and adherence · 2021Review
- Factors affecting adherence to antiretroviral therapy among pregnant women in the Eastern Cape, South Africa.BMC infectious diseases · 2018Article
- Adoption of injectable naltrexone in U.S. substance use disorder treatment programs.Journal of studies on alcohol and drugs · 2015Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundThe primary analyses of the COMBINE Study revealed significant naltrexone and Combined Behavioral Intervention (CBI) main effects on drinking outcomes but failed to find additional benefits of the combination of treatments. Investigating differences in patterns of adherence over time may shed light on the treatment effects in COMBINE. The goals of the study were to identify trajectories of medication adherence and participation in CBI, to estimate predictive and moderating effects of adherence trajectories on drinking outcomes and to characterize subjects in adherence trajectories. The results of these analyses may suggest approaches to improving adherence in order to ultimately improve treatment outcome.
methodsWe used a trajectory-based approach to identify patterns of treatment adherence separately for naltrexone, acamprosate and CBI adherence. Logistic regression and general linear models assessed associations among adherence trajectories, drinking outcomes and patient characteristics.
resultsThree trajectories of adherence were identified for each treatment: "excellent adherers", "late non-adherers" and "early non-adherers" and there was good agreement among adherence trajectories with different treatments. "Excellent adherers" had significantly higher percent days abstinent (PDA) and lower percent heavy drinking days (PHDD). CBI significantly decreased PHDD for subjects on acamprosate in the "early non-adherers with medication" trajectory (p=0.01). Either naltrexone or acamprosate was associated with lower PHDD than placebo for "early non-adherers with CBI" (p<0.01). Receiving active medication decreased the likelihood to be in the excellent medication adherence trajectory. Younger age, greater drinking severity, dissatisfaction with the medicine and session frequency, adverse events and lack of benefit were related to less favorable medication adherence trajectories. "Excellent adherers with CBI" were significantly more satisfied with the CBI counselor.
conclusionsPatterns of treatment adherence appear to be a participant characteristic. Individuals who fail to adhere early in treatment have worse outcomes regardless of treatment. However, treatment outcomes of participants who exhibit early problems with adherence to one treatment modality could potentially be improved by offering an alternative behavioral or pharmacologic treatment.
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