Evaluation of adding the community reinforcement approach to motivational enhancement therapy for adults aged 60 years and older with DSM‐5 alcohol use disorder: a randomized controlled trial

• DOI: 10.1111/add.14795
• Publication Date: 2019-08-27T17:48:30Z
• Authors: Kjeld Andersen; Silke Behrendt; Randi Bilberg; Michael P. Bogens...; Barbara Braun; Gerhard Buehringer; Claus Thorn Ekstrøm; Anna Mejldal; Anne Helby Petersen; Anette Søgaard Ni...
• Keywords: Alcohol use disorder; Alcohol Dependence; Relapse prevention

Abstract Aim To examine whether adding the Community Reinforcement Approach for Seniors (CRA‐S) to Motivational Enhancement Therapy (MET) increases probability of treatment success in people aged ≥ 60 years with alcohol use disorder (AUD). Design A single blind multi‐centre multi‐national randomized (1 : 1) controlled trial. Setting Out‐patient settings (municipal clinics Denmark, specialized addiction care facilities Germany and a primary clinic United States). Participants Between January 2014 May 2016, 693 patients 60+ fulfilling DSM‐5 criteria AUD participated comparing MET ( n = 351) + CRA‐S 342). Intervention comparator (comparator) included four manualized sessions aimed at increasing motivation change establishing plan. (intervention) consisted up eight further optional, helping implement their specially designed module on coping age age‐related problems. Measurements The outcome was either total abstinence or an expected blood concentration ≤ 0.05% during 30 days preceding 26 weeks follow‐up (defined as success) > period failure). This assessed by self‐report using Form 90 instrument. main analysis involved complete cases. Findings rate 76.2% (76.9% group 76.0% group). 48.9% [95% confidence interval (CI) 42.9–54.9%] versus 52.3% (95% CI 46.2–58.3%) group. odds two conditions did not differ (odds ratio 1.22. 95% 0.86–1.75, P 0.26, Bayes factor 0.10). Sensitivity analyses involving alternative approaches missing values results. Conclusions In older adults diagnosis, ‘community reinforcement approach seniors’ intervention brief out‐patient motivational enhancement therapy improve drinking outcome.