Effect of community nurse follow-up when treating alcohol dependence with acamprosate

Aims: To measure the effect of community nurse follow-up on abstinence and retention rates in the outpatient treatment of alcohol-dependent patients treated with acamprosate. Methods: Recently detoxified alcohol-dependent patients were prescribed acamprosate for 26 weeks and randomized to either physician-only follow-up, or physician plus regular visits from a community nurse. Drinking behaviour in the next 26 weeks was assessed at monthly visits to non-blind clinicians. Results: The cumulative abstinence duration proportion (CADP) was significantly longer in (P = 0.03) the subjects who had received community nurse support (0.57) than in those who had not (0.39). This might, in part, be an artefact of the higher retention rate among those followed up by the nurse, in that, the method of calculating CADP allocates 100% days of drinking for the month before a failed attendance. Differences favouring nurse in the follow-up were seen for time to first drink, and clinical global impression. Conclusions: For recently detoxified alcohol-dependent patients treated with acamprosate, follow-up by a community nurse improves patient retention and probably also improves the 6-month drinking outcome