Determine whether 18 months of telephone continuing care improves 24 month outcomes for patients with alcohol dependence. Subgroup analyses were done to identify patients who would most benefit from continuing care.
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.
Publicly funded intensive outpatient programs (IOP)
252 alcohol dependent patients (49% with current cocaine dependence) who completed 3 weeks of IOP.
Percent days drinking, any heavy drinking, and a composite good clinical outcome.
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. Approximately 50% of participants met criteria for Good Clinical Outcomes throughout treatment and follow-up with a non-significant trend for TMC to perform better than usual care. 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 2 of 3 outcomes. However, no effects remained significant at 24 months.
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.
Keywords: comparative effectiveness study, alcohol dependence, continuing care, telephone counseling, monitoring and feedback