Monitoring adherence and abstinence of cannabis use disorder patients: Profile identification and relationship with long-term treatment outcomes

Daniel Dacosta-Sánchez; Fermín Fernández-Calderón; Andrea Blanc-Molina; Carmen Díaz-Batanero; Oscar M Lozano

doi:10.1016/j.josat.2023.209019

Monitoring adherence and abstinence of cannabis use disorder patients: Profile identification and relationship with long-term treatment outcomes

J Subst Use Addict Treat. 2023 May:148:209019. doi: 10.1016/j.josat.2023.209019. Epub 2023 Mar 16.

Authors

Daniel Dacosta-Sánchez¹, Fermín Fernández-Calderón², Andrea Blanc-Molina¹, Carmen Díaz-Batanero², Oscar M Lozano³

Affiliations

¹ Department of Clinical and Experimental Psychology, University of Huelva. Avda. Fuerzas Armadas s/n. 21071, Huelva, Spain.
² Department of Clinical and Experimental Psychology, University of Huelva. Avda. Fuerzas Armadas s/n. 21071, Huelva, Spain; Research Center on Natural Resources, Health and the Environment, University of Huelva, Ed. Experimental Sciences, 21071 Huelva, Spain.
³ Department of Clinical and Experimental Psychology, University of Huelva. Avda. Fuerzas Armadas s/n. 21071, Huelva, Spain; Research Center on Natural Resources, Health and the Environment, University of Huelva, Ed. Experimental Sciences, 21071 Huelva, Spain. Electronic address: oscar.lozano@dpsi.uhu.es.

PMID: 36933660
DOI: 10.1016/j.josat.2023.209019

Abstract

Background: Patients with cannabis use disorder (CUD) show heterogeneous sociodemographic and consumption patterns. Although previous studies, focused on identifying subgroups of CUD patients using input variables, have yielded useful results for planning individualized treatments, no published research has analyzed the profiles of CUD patients according to their therapeutic progress. This study therefore aims to identify subgroups of patients using adherence and abstinence indicators and to explore whether these profiles are associated with sociodemographic characteristics, consumption variables, and long-term therapeutic outcomes.

Methods: This was a retrospective observational study with a multisite sample of 2055 CUD outpatients who were beginning treatment. The study monitored patient data at two-year follow-up. We conducted latent profiles analysis on the appointment attendance ratio and percentage of negative cannabis tests.

Results: A three profile solution emerged: i) moderate abstinence/moderate adherence (n = 997); ii) high abstinence/moderate adherence (n = 613); and iii) high abstinence/high adherence (n = 445). The study found the most marked differences at the beginning of treatment for education level (chi² (8) = 121.70, p < .001), source of referral (chi² (12) = 203.55, p < .001), and frequency of cannabis use (chi² (10) = 232.39, p < .001). Eighty percent of patients from the "high abstinence/high adherence" group were relapse-free at two year follow-up. This percentage decreased to 24.3 % in the "moderate abstinence/moderate adherence" group.

Conclusions: Research has shown adherence and abstinence indicators to be useful for identifying subgroups of patients with different prognoses regarding long-term success. Recognizing the sociodemographic and consumption variables associated with these profiles at the beginning of treatment could help to inform the design of more individualized interventions.

Keywords: Cannabis use disorder; Latent profile; Outcomes; Relapse; Treatment.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Aged
Female
Follow-Up Studies
Humans
Male
Marijuana Abuse* / diagnosis
Marijuana Abuse* / psychology
Marijuana Abuse* / rehabilitation
Marijuana Abuse* / therapy
Middle Aged
Patient Dropouts
Patients* / psychology
Prognosis
Recurrence
Retrospective Studies
Treatment Adherence and Compliance*
Treatment Outcome
Young Adult