Program Reviews

The Adaptive Goal-Directed Adherence Tracking and Enhancement (AGATE) system

Program Overview

AGATE uses text messaging to improve adherence to naltrexone treatment for alcohol use disorders.

AGATE is a smartphone recovery support application that sends text messages for medication reminders to people receiving naltrexone treatment. The program also includes links to assessments to track medication adherence, and drinking frequ ency and urges. Users meet with their naltrexone providers and set adherence goals before using AGATE. Over three stages, AGATE gradually steps down reminder and assessment frequency based on users’ success in meeting their adherence goals. If users don’t meet their goals, AGATE increases reminder and assessment frequency. Users also receive feedback on their performance.

Delivery:
Smartphone

Theoretical Approaches:
Adaptive goal-directed adherence

Target Substance(s):
Alcohol

Target Outcome(s):
Improve naltrexone adherence
Reduce drinking and urges to drink

Ages:
Young Adults (18-30)
Adults (30+)

Genders:
Male
Female

Races/Ethnicities:
Caucasian
Hispanic/Latino
Other

Setting:
Remote Access

Geographic Location:
Unspecified

Country:
USA

Language:
English

Evaluations

  • Stoner SA, Arenella PB, Hendershot CS. PLOS ONE. 2015. 10(4):e0124613. PMCID: PMC4409303.

    Summary:  This randomized controlled trial tested the efficacy of AGATE to improve naltrexone adherence for individuals with alcohol use disorders. Seventy-six adults with alcohol use disorders were recruited and prescribed naltrexone. Participants were randomized to AGATE or a control condition. In the AGATE condition, participants received a smartphone with eight weeks of unlimited service, as well as AGATE text message reminders. Participants completed assessments on the phones to track medication adherence, alcohol use and medication side effects. The control group received a smartphone and completed alcohol use and medication use and side effect assessments, but did not receive  text message reminders. Naltrexone adherence and drinking outcomes were measured atbaseline, 4 weeks, and 8 weeks. There were no significant differences between the AGATE and control groups in medication adherence at weeks 4 or 8. Despite this, control group participants showed reductions in naltrexone adherence significantly earlier than those in the AGATE group. No differences in drinking outcomes were detected.

    Take Away:  The medication reminder text messages of AGATE did not appear to improve naltrexone adherence or drinking outcomes for adults prescribed naltrexone for alcohol use disorders.

  • A randomized trial evaluating an mHealth system to monitor and enhance adherence to pharmacotherapy for alcohol use disorders.Stoner SA, Hendershot CS. Addiction Science and Clinical Practice. 2012. 7:9. PMCID: PMC3507635.