Does assertive community treatment increase medication adherence for people with co-occurring psychotic and substance use disorders?

Jennifer I. Manuel, Nancy H. Covell, Carlos T. Jackson, Susan M. Essock

    Research output: Contribution to journalArticle

    Abstract

    OBJECTIVE: This study analyzed data from a randomized trial to examine the impact on medication adherence of integrated treatment delivered via assertive community treatment (ACT) versus standard clinical case management (SCCM). METHOD: Data from the original study included 198 study participants with co-occurring psychotic and substance use disorders who were randomly assigned to receive integrated treatment via ACT or SCCM and were followed for 3 years. We applied mixed-effects logistic regression to estimate group (ACT vs. SCCM) by time effects on a self-report measure of medication adherence. Adherence was dichotomized as 20% or more missed medication days ("poor adherence") versus less than 20% missed medication days ("adequate adherence"). RESULTS: Participants who were assigned to ACT reported significant improvement in medication adherence compared with those assigned to SCCM. CONCLUSIONS: Integrated treatment delivered via ACT may benefit persons with co-occurring psychotic and substance use disorders who are poorly adherent to medications.

    Original languageEnglish (US)
    Pages (from-to)51-56
    Number of pages6
    JournalJournal of the American Psychiatric Nurses Association
    Volume17
    Issue number1
    DOIs
    StatePublished - Jan 1 2011

    Fingerprint

    Community Mental Health Services
    Medication Adherence
    Substance-Related Disorders
    Case Management
    Self Report
    Logistic Models

    Keywords

    • assertive community treatment (ACT)
    • chronic mental illness
    • dual disorders
    • medication adherence

    ASJC Scopus subject areas

    • Phychiatric Mental Health

    Cite this

    Does assertive community treatment increase medication adherence for people with co-occurring psychotic and substance use disorders? / Manuel, Jennifer I.; Covell, Nancy H.; Jackson, Carlos T.; Essock, Susan M.

    In: Journal of the American Psychiatric Nurses Association, Vol. 17, No. 1, 01.01.2011, p. 51-56.

    Research output: Contribution to journalArticle

    @article{a4eca04c661c42a684cf5a1e399d0a26,
    title = "Does assertive community treatment increase medication adherence for people with co-occurring psychotic and substance use disorders?",
    abstract = "OBJECTIVE: This study analyzed data from a randomized trial to examine the impact on medication adherence of integrated treatment delivered via assertive community treatment (ACT) versus standard clinical case management (SCCM). METHOD: Data from the original study included 198 study participants with co-occurring psychotic and substance use disorders who were randomly assigned to receive integrated treatment via ACT or SCCM and were followed for 3 years. We applied mixed-effects logistic regression to estimate group (ACT vs. SCCM) by time effects on a self-report measure of medication adherence. Adherence was dichotomized as 20{\%} or more missed medication days ({"}poor adherence{"}) versus less than 20{\%} missed medication days ({"}adequate adherence{"}). RESULTS: Participants who were assigned to ACT reported significant improvement in medication adherence compared with those assigned to SCCM. CONCLUSIONS: Integrated treatment delivered via ACT may benefit persons with co-occurring psychotic and substance use disorders who are poorly adherent to medications.",
    keywords = "assertive community treatment (ACT), chronic mental illness, dual disorders, medication adherence",
    author = "Manuel, {Jennifer I.} and Covell, {Nancy H.} and Jackson, {Carlos T.} and Essock, {Susan M.}",
    year = "2011",
    month = "1",
    day = "1",
    doi = "10.1177/1078390310395586",
    language = "English (US)",
    volume = "17",
    pages = "51--56",
    journal = "Journal of the American Psychiatric Nurses Association",
    issn = "1078-3903",
    publisher = "SAGE Publications Inc.",
    number = "1",

    }

    TY - JOUR

    T1 - Does assertive community treatment increase medication adherence for people with co-occurring psychotic and substance use disorders?

    AU - Manuel, Jennifer I.

    AU - Covell, Nancy H.

    AU - Jackson, Carlos T.

    AU - Essock, Susan M.

    PY - 2011/1/1

    Y1 - 2011/1/1

    N2 - OBJECTIVE: This study analyzed data from a randomized trial to examine the impact on medication adherence of integrated treatment delivered via assertive community treatment (ACT) versus standard clinical case management (SCCM). METHOD: Data from the original study included 198 study participants with co-occurring psychotic and substance use disorders who were randomly assigned to receive integrated treatment via ACT or SCCM and were followed for 3 years. We applied mixed-effects logistic regression to estimate group (ACT vs. SCCM) by time effects on a self-report measure of medication adherence. Adherence was dichotomized as 20% or more missed medication days ("poor adherence") versus less than 20% missed medication days ("adequate adherence"). RESULTS: Participants who were assigned to ACT reported significant improvement in medication adherence compared with those assigned to SCCM. CONCLUSIONS: Integrated treatment delivered via ACT may benefit persons with co-occurring psychotic and substance use disorders who are poorly adherent to medications.

    AB - OBJECTIVE: This study analyzed data from a randomized trial to examine the impact on medication adherence of integrated treatment delivered via assertive community treatment (ACT) versus standard clinical case management (SCCM). METHOD: Data from the original study included 198 study participants with co-occurring psychotic and substance use disorders who were randomly assigned to receive integrated treatment via ACT or SCCM and were followed for 3 years. We applied mixed-effects logistic regression to estimate group (ACT vs. SCCM) by time effects on a self-report measure of medication adherence. Adherence was dichotomized as 20% or more missed medication days ("poor adherence") versus less than 20% missed medication days ("adequate adherence"). RESULTS: Participants who were assigned to ACT reported significant improvement in medication adherence compared with those assigned to SCCM. CONCLUSIONS: Integrated treatment delivered via ACT may benefit persons with co-occurring psychotic and substance use disorders who are poorly adherent to medications.

    KW - assertive community treatment (ACT)

    KW - chronic mental illness

    KW - dual disorders

    KW - medication adherence

    UR - http://www.scopus.com/inward/record.url?scp=79952302498&partnerID=8YFLogxK

    UR - http://www.scopus.com/inward/citedby.url?scp=79952302498&partnerID=8YFLogxK

    U2 - 10.1177/1078390310395586

    DO - 10.1177/1078390310395586

    M3 - Article

    C2 - 21659294

    AN - SCOPUS:79952302498

    VL - 17

    SP - 51

    EP - 56

    JO - Journal of the American Psychiatric Nurses Association

    JF - Journal of the American Psychiatric Nurses Association

    SN - 1078-3903

    IS - 1

    ER -