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Increasing Treatment Adherence in Co-Occurring Psychiatric and Drug Use Disorders

The recruitment status of this study is unknown. The completion date has passed and the status has not been verified in more than two years.
Verified October 2005 by National Institute on Drug Abuse (NIDA).
Recruitment status was:  Recruiting
Yale University
Information provided by:
National Institute on Drug Abuse (NIDA) Identifier:
First received: October 7, 2005
Last updated: March 2, 2006
Last verified: October 2005

The investigators are proposing a study of treatment adherence in co-occurring psychiatric and drug use disorders (COD). The proposed study uses a 3-cell/condition design, within which 75 adult outpatients with co-occurring psychiatric disorders and drug abuse/dependence (CODDA) will be randomly assigned to one of the following brief, 8-week, manual-guided interventions following a 2-week “Assessment Only” baseline period:

  1. Adherence Feedback (AF); this condition will entail weekly, 20-25 minute sessions of AF, which is a procedure that represents a technological advancement developed by Cramer et al. (1989, 1995, and 1999) and is based on the use of adherence data from the microelectronic monitor in Medication Event Monitoring System (MEMS) caps,
  2. AF + Contingency Management (AF + CM); in this condition, participants will receive AF, as described above, PLUS contingency management. CM is based on the behavioral learning theory, which suggests that the occurrence of a behavior is increased as a function of the rate at which it is positively reinforced or rewarded, or
  3. AF + Motivational Enhancement Therapy (AF + MET); in this condition, patients will receive AF, as described above, PLUS motivational enhancement therapy. MET is based on the idea that an effective way to motivate behavior change is to assist patients in clarifying their ambivalence (i.e., reasons for and against changing/adhering), utilizing a series of strategies based on client-centered psychotherapy, self-efficacy theory, and social psychology.

The study will allow the evaluation of three hypotheses:

  1. AF + MET is superior to AF + CM,
  2. AF + MET is superior to AF alone, and
  3. AF + CM is superior to AF alone.

Primary outcome measures are:

  1. rates of adherence to medication (i.e., selective serotonin reuptake inhibitors or SSRIs), as measured by MEMS caps and self-report,
  2. rates of counseling attendance, and
  3. reductions in illicit drug use, including achievement of abstinence, as assessed by twice-weekly urine toxicology tests and self-report.

Secondary outcomes include reductions in psychiatric symptomatology and rates of re-hospitalization. The investigators will also evaluate the relationship between adherence and primary and secondary outcomes.

Condition Intervention Phase
Diagnosis, Dual (Psychiatry) Psychiatric Diagnosis Drug Use Disorders Behavioral: Adherence Feedback (AF) Behavioral: AF + Contingency Management (AF + CM) Behavioral: AF + Motivational Enhancement Therapy (AF + MET) Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single
Primary Purpose: Educational/Counseling/Training
Official Title: Increasing Treatment Adherence in Co-Occurring Disorders

Further study details as provided by National Institute on Drug Abuse (NIDA):

Primary Outcome Measures:
  • Treatment adherence

Secondary Outcome Measures:
  • Drug use
  • Depression

Estimated Enrollment: 75
Study Start Date: September 2003
Estimated Study Completion Date: December 2007

Ages Eligible for Study:   18 Years to 85 Years   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Currently being treated with any class of psychotropic medication
  • Have used illicit drugs or abused prescription drugs within the past year
  • Are not adhering completely to their medication

Exclusion Criteria:

  • Current major depressive episode
  • Active suicidal/homicidal ideation/intent
  • Current manic episode
  • Visiting nurse or living in a facility that distributed medications
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT00237822

Contact: Michael V. Pantalon, Ph.D. 203-974-7596
Contact: Meaghan E. Lavery, B.A. 203-974-7543

United States, Connecticut
Yale University Substance Abuse Center Recruiting
New Haven, Connecticut, United States, 06519
Sponsors and Collaborators
National Institute on Drug Abuse (NIDA)
Yale University
Principal Investigator: Michael V. Pantalon, Ph.D. Yale University
  More Information Identifier: NCT00237822     History of Changes
Other Study ID Numbers: K23DA015144 ( U.S. NIH Grant/Contract )
Study First Received: October 7, 2005
Last Updated: March 2, 2006

Keywords provided by National Institute on Drug Abuse (NIDA):
Treatment Adherence
Co-Occurring Disorders
Motivational Enhancement Therapy
Contingency Management

Additional relevant MeSH terms:
Substance-Related Disorders
Mental Disorders
Pathologic Processes
Chemically-Induced Disorders processed this record on September 18, 2017