Increasing adherence to therapy

“Drugs don’t work in patients who don’t take them”, as famously stated by C. Everett Koop, the former Surgeon General.⁵ Therefore it is important, when considering medication for substance-use disorders, to consider adherence to that medication. As outlined on the slide, there are some behavioural counselling techniques, and some approaches to drug formulation, that can aid patient adherence.^1,2,3,4

References:
[1] Hollands GJ, Naughton F, Farley A, et al. Interventions to increase adherence to medications for tobacco dependence. Cochrane Database Syst Rev 2019; 8 (8): CD009164.

[2] Murphy CE 4th, Wang RC, Montoy JC, et al. Effect of extended-release naltrexone on alcohol consumption: a systematic review and meta-analysis. Addiction 2022; 117 (2): 271–281.

[3] NICE. Opioid dependence: buprenorphine prolonged-release injection (Buvidal), 14 February 2019. Available at: https://www.nice.org.uk/advice/es19/resources/opioid-dependence-buprenorphine-prolongedrelease-injection-buvidal-pdf-1158123740101. Accessed September 2022.

[4] Lofwall MR, Walsh SL, Nunes EV, et al. Weekly and monthly subcutaneous buprenorphine depot formulations vs daily sublingual buprenorphine with naloxone for treatment of opioid use disorder: a randomized clinical trial. JAMA Intern Med 2018; 178 (6): 764–773.

[5] Osterberg L, Blaschke T. Adherence to medication. N Engl J Med 2005; 353 (5): 487–497.