Objectives: Alcohol use disorder (AUD) is a chronic relapsing condition, and while disulfiram remains an effective deterrent therapy, its success is largely dependent on adherence. Evidence suggests that better adherence is directly linked to improved treatment outcomes. This article, derived from a larger thesis, focuses on two parameters – adherence assessed by the medication adherence rating scale (MARS) and therapeutic outcomes measured using the AUDs identification test (AUDIT) – to evaluate the clinical effectiveness of disulfiram in AUD. Materials and Methods: The present prospective observational study was carried out over a period of 1 year in the Psychiatry Outpatient Department at King George’s Medical University, Lucknow. Ninety-one patients aged 18–60 years, diagnosed with AUD as per DSM-5 criteria and prescribed disulfiram 250 mg daily and were enrolled after informed consent. Adherence was assessed using the MARS, and therapeutic outcomes were evaluated using the AUDIT at baseline, 4 weeks and 8 weeks. Statistical analysis included the Wilcoxon signed-rank test and Pearson correlation, with P < 0.05 considered statistically significant. Results: At 4 weeks, the mean MARS score was 3.57 ± 0.85, which increased significantly to 5.55 ± 1.18 at 8 weeks ( P < 0.001). Mean AUDIT scores showed a progressive decline from 28.18 ± 4.49 at baseline to 25.19 ± 4.52 at 4 weeks and 22.80 ± 4.70 at 8 weeks, with all reductions significant ( P < 0.001). Correlation analysis revealed no significant association between adherence and AUDIT scores at 8 weeks ( r = –0.083, P = 0.436). Conclusion: Disulfiram therapy significantly improved medication adherence and reduced alcohol use severity in patients with AUD. However, adherence and therapeutic outcomes did not show a direct correlation at 8 weeks, indicating that additional psychosocial support may be essential to sustain recovery.
Khan et al. (Mon,) studied this question.