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Improving adherence in patients with alcohol dependence: A new role for pharmacists

 Andrew M. Peterson

ANDREW M. PETERSON, PHARM.D., is Associate Professor of Clinical Pharmacy and Chair, Department of Pharmacy Practice/Pharmacy Administration, Philadelphia College of Pharmacy, University of the Sciences in Philadelphia, 600 South 43rd Street, Philadelphia, PA 19102 (a.peters{at}usip.edu).


Purpose. To review medication adherence rates with various pharmacotherapies and the role of pharmacists in improving medication adherence in patients with alcohol dependence.

Summary. Nonadherence diminishes the effectiveness of treatment for all chronic diseases, including alcohol dependence. Rates of adherence to pharmacotherapies for alcohol dependence range widely, both within and among agents. Factors undermining adherence include high pill burden and adverse effects, both of which occur with common treatments for alcohol dependence. There is a clear need for interventions that improve patient adherence to treatment.

Conclusion. Adherence-enhancing psychosocial interventions have demonstrated some efficacy, but there is a dearth of controlled trials on this subject. Pharmacist-based interventions have successfully identified and treated nonadherence in other chronic disease states, utilizing tools such as medication reminders, extended-release formulations, and patient education. Similar interventions may improve treatment adherence, and thus drinking outcomes, in patients with alcohol dependence.

Index terms: Alcohol deterrents; Alcoholism; Alcohols, ethyl; Compliance; Dependence; Interventions; Patients; Pharmacists; Toxicity

 





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