Factors influencing adherence to anti‑craving medications and drinking outcomes in patients with alcohol dependence: A hospital‑based study

Objective: To examine the factors influencing the pattern and extent of anti-craving medication adherence and drinking outcomes in alcohol-dependent patients. Materials and Methods: Demographic data from 102 inpatients were collected at discharge from hospital. The pattern of anti‑craving medication, extent of adherence, and drinking outcome was collected at 1st, 3rd, 8th, and 12th week follow‑up. Patients’ self‑reported adherence, medication diary, and simplified medication adherence questionnaire were used and data were analyzed using SPSS. Results: Majority (99%) were male patients with a mean age of 41.17 ± 9.86 years and 70% belonged to middle socioeconomic status. There was a decrease in the number of patients coming for follow‑up over time from 99.01% to 77.45% on day 90. Acamprosate was used in 74% and naltrexone and disulfiram in 7% of patients each. A significant reduction in adherence to acamprosate and naltrexone (P < 0.001) was associated with simultaneous decrease in days to alcohol abstinence and increase in relapse rate compared to adherent group (P < 0.001). Main barriers to adherence included younger age (odds ratio = 1.05 95% [1.01–1.09]; P < 0.01), self‑decision, emotional factors, and adverse effects. Conclusions: The study demonstrated the need for safer therapeutic options along with suitable intervention at “grass root level” for sustenance of adherence to anti‑craving medication among young adults to prevent relapse and achieve near‑complete abstinence from alcohol dependence.