The Article in Brief

An Intervention for Treating Alcohol Dependence: Relating Elements of Medical Management to Patient Outcomes With Implications for Primary Care

Denise B. Ernst , and colleagues

Background This study examines factors in the relationship between patient, clinician, and treatment results in a program to treat alcohol dependence. The program, conducted in sites affiliated with academic alcohol research programs, has found that patients who receive the drug naltrexone plus a Medical Management approach significantly reduce their drinking. (In the Medical Management approach, patients work with a clinician to learn about alcohol dependence, develop treatment and follow-up plans, and monitor their progress).

What This Study Found Patients who attend more visits reduce their drinking and have better clinical results. Patients' positive views of the relationship with their clinician, as well as their satisfaction with treatment, predict more days of abstinence from alcohol during treatment. In this study, participating clinicians were generally warm and informative, provided direction, and followed and completed the study plan. They help improve patient results if they show confidence in the treatment and are flexible in delivering it.

Implications

• This approach to alcohol treatment may be suitable for the primary care setting.
• Using effective medications and managing alcohol dependence in primary care could make treatment more available and lower the stigma related to asking for and receiving treatment for alcohol problems.