Exploring the impact of a medication adherence intervention on recovery and mental health outcomes: A secondary analysis of the MAT-PLUS pilot RCT

Background: Substance use disorders (SUDs) including opioid use disorder (OUD) and alcohol use disorder (AUD) contribute to significant morbidity and mortality in the United States. Pharmacotherapy treatment, including extended-release naltrexone (XR-NTX), is underutilized in large part due to poor...

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Main Authors: Kevin Wenzel, Julia Thomas, Jennifer Carrano, Jennifer Stidham, Marc Fishman
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Drug and Alcohol Dependence Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772724625000290
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author Kevin Wenzel
Julia Thomas
Jennifer Carrano
Jennifer Stidham
Marc Fishman
author_facet Kevin Wenzel
Julia Thomas
Jennifer Carrano
Jennifer Stidham
Marc Fishman
author_sort Kevin Wenzel
collection DOAJ
description Background: Substance use disorders (SUDs) including opioid use disorder (OUD) and alcohol use disorder (AUD) contribute to significant morbidity and mortality in the United States. Pharmacotherapy treatment, including extended-release naltrexone (XR-NTX), is underutilized in large part due to poor treatment retention. The MAT-PLUS (Medication Adherence Therapy: Psychosocial Leverage Using a Significant other) intervention combines assertive outreach, significant other involvement, and low-barrier access to medicine to improve retention on XR-NTX, and has shown promising results in a pilot RCT. Methods: This report explored secondary outcomes from the MAT-PLUS pilot RCT (NCT03567356) to determine the impact of the intervention on recovery experience as measured by the Recovery Assessment Scale (RAS) and mental health indicators as measured by the patient health questionnaire- somatic, anxiety, depression scale (PHQ-SADS) on N = 41 participants. Results: A series of repeated measures mixed ANOVAs did not find evidence of an effect of the MAT-PLUS intervention on these outcomes. Although total RAS scores did not improve over time in either condition, an independent samples t-test at the post-intervention follow up suggested some evidence of a possible treatment effect on two subscales of the RAS: 1) Not being dominated by symptoms and 2) Goal and success orientation. Discussion: The results of this study suggest that mental health symptoms are attenuated during treatment, whether usual care or the MAT-PLUS intervention, but that recovery indicators did not improve with treatment. Approaches to SUD care, including the MAT-PLUS intervention, should be refined to target improvements in recovery capital in addition to focusing on symptom reduction.
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spelling doaj-art-6d88bed3a6694e7cb28d19e603b3fc762025-08-20T02:32:31ZengElsevierDrug and Alcohol Dependence Reports2772-72462025-06-011510034610.1016/j.dadr.2025.100346Exploring the impact of a medication adherence intervention on recovery and mental health outcomes: A secondary analysis of the MAT-PLUS pilot RCTKevin Wenzel0Julia Thomas1Jennifer Carrano2Jennifer Stidham3Marc Fishman4Maryland Treatment Centers, 3800 Frederick Ave, Baltimore, MD 21229, USA; Corresponding author.Maryland Treatment Centers, 3800 Frederick Ave, Baltimore, MD 21229, USAMaryland Treatment Centers, 3800 Frederick Ave, Baltimore, MD 21229, USAMaryland Treatment Centers, 3800 Frederick Ave, Baltimore, MD 21229, USA; Wayne State University, 5057 Woodward Ave, Detroit, MI 48202, USAMaryland Treatment Centers, 3800 Frederick Ave, Baltimore, MD 21229, USA; Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 600 North Wolfe Street, Baltimore, MD 21287, USABackground: Substance use disorders (SUDs) including opioid use disorder (OUD) and alcohol use disorder (AUD) contribute to significant morbidity and mortality in the United States. Pharmacotherapy treatment, including extended-release naltrexone (XR-NTX), is underutilized in large part due to poor treatment retention. The MAT-PLUS (Medication Adherence Therapy: Psychosocial Leverage Using a Significant other) intervention combines assertive outreach, significant other involvement, and low-barrier access to medicine to improve retention on XR-NTX, and has shown promising results in a pilot RCT. Methods: This report explored secondary outcomes from the MAT-PLUS pilot RCT (NCT03567356) to determine the impact of the intervention on recovery experience as measured by the Recovery Assessment Scale (RAS) and mental health indicators as measured by the patient health questionnaire- somatic, anxiety, depression scale (PHQ-SADS) on N = 41 participants. Results: A series of repeated measures mixed ANOVAs did not find evidence of an effect of the MAT-PLUS intervention on these outcomes. Although total RAS scores did not improve over time in either condition, an independent samples t-test at the post-intervention follow up suggested some evidence of a possible treatment effect on two subscales of the RAS: 1) Not being dominated by symptoms and 2) Goal and success orientation. Discussion: The results of this study suggest that mental health symptoms are attenuated during treatment, whether usual care or the MAT-PLUS intervention, but that recovery indicators did not improve with treatment. Approaches to SUD care, including the MAT-PLUS intervention, should be refined to target improvements in recovery capital in addition to focusing on symptom reduction.http://www.sciencedirect.com/science/article/pii/S2772724625000290Medication adherenceOpioid use disorderAlcohol use disorderExtended-release naltrexoneAssertive outreach
spellingShingle Kevin Wenzel
Julia Thomas
Jennifer Carrano
Jennifer Stidham
Marc Fishman
Exploring the impact of a medication adherence intervention on recovery and mental health outcomes: A secondary analysis of the MAT-PLUS pilot RCT
Drug and Alcohol Dependence Reports
Medication adherence
Opioid use disorder
Alcohol use disorder
Extended-release naltrexone
Assertive outreach
title Exploring the impact of a medication adherence intervention on recovery and mental health outcomes: A secondary analysis of the MAT-PLUS pilot RCT
title_full Exploring the impact of a medication adherence intervention on recovery and mental health outcomes: A secondary analysis of the MAT-PLUS pilot RCT
title_fullStr Exploring the impact of a medication adherence intervention on recovery and mental health outcomes: A secondary analysis of the MAT-PLUS pilot RCT
title_full_unstemmed Exploring the impact of a medication adherence intervention on recovery and mental health outcomes: A secondary analysis of the MAT-PLUS pilot RCT
title_short Exploring the impact of a medication adherence intervention on recovery and mental health outcomes: A secondary analysis of the MAT-PLUS pilot RCT
title_sort exploring the impact of a medication adherence intervention on recovery and mental health outcomes a secondary analysis of the mat plus pilot rct
topic Medication adherence
Opioid use disorder
Alcohol use disorder
Extended-release naltrexone
Assertive outreach
url http://www.sciencedirect.com/science/article/pii/S2772724625000290
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