Extended telephone-based continuing care for alcohol dependence: 24-month outcomes and subgroup analyses
Article first published online: 8 AUG 2011
© 2011 The Authors, Addiction © 2011 Society for the Study of Addiction
Volume 106, Issue 10, pages 1760–1769, October 2011
How to Cite
McKay, J. R., Van Horn, D., Oslin, D. W., Ivey, M., Drapkin, M. L., Coviello, D. M., Yu, Q. and Lynch, K. G. (2011), Extended telephone-based continuing care for alcohol dependence: 24-month outcomes and subgroup analyses. Addiction, 106: 1760–1769. doi: 10.1111/j.1360-0443.2011.03483.x
- Issue published online: 14 SEP 2011
- Article first published online: 8 AUG 2011
- Accepted manuscript online: 6 MAY 2011 04:39AM EST
- Submitted 9 September 2010; initial review completed 30 November 2010; final version accepted 27 April 2011
- Alcohol dependence;
- continuing care;
- comparative effectiveness study;
- monitoring and feedback;
- telephone counselling
Aims To determine whether 18 months of telephone continuing care improves 24-month outcomes for patients with alcohol dependence. Subgroup analyses were performed to identify patients who would benefit most from continuing care.
Design Comparative effectiveness trial of continuing care that consisted of monitoring and feedback only (TM) or monitoring and feedback plus counseling (TMC). Patients were randomized to treatment as usual (TAU), TAU plus TM or TAU plus TMC, and followed quarterly for 24 months.
Setting Publicly funded intensive out-patient programs (IOP).
Participants A total of 252 alcohol-dependent patients (49% with current cocaine dependence) who completed 3 weeks of IOP.
Measurements Percentage of days drinking, any heavy drinking and a composite good clinical outcome.
Findings In the intent-to-treat sample, group differences in alcohol outcomes out to 18 months favoring TMC over TAU were no longer present in months 19–24. There was also a non-significant trend for TMC to perform better than usual care on the good clinical outcome measure (60% vs. 46% good clinical outcome in months 19–24). Overall significant effects favoring TMC and TM over TAU were seen for women; and TMC was also superior to TAU for participants with social support for drinking, low readiness to change and prior alcohol treatments. Most of these effects were obtained on at least two of three outcomes. However, no effects remained significant at 24 months.
Conclusions The benefits of an extended telephone-based continuing care programme to treat alcohol dependence did not persist after the end of the intervention. A post-hoc analysis suggested that women and individuals with social support for drinking, low readiness to change or prior alcohol treatments may benefit from the intervention.