ASSESSMENT OF MEDICATION COMPLIANCE IN ALCOHOLICS THROUGH UV-LIGHT DETECTION OF A RIBOFLAVIN TRACER

Compliance with the medication regimen in treatment trials for alcohol ism appears to be a key determinant of treatment outcome, However, the re is no consensus as to the best method to assess medication complian ce, This study examines the feasibility of using ultraviolet light det ection of a urinary riboflavin tracer to determine compliance with med ication therapy. Six sets of urine specimens (with n ranging from 15 t o 38) were rated independently by two judges, Test-retest reliability was high: 90 and 95% agreement for two judges. Inter-rater reliability ranged from 73 to 95% agreement between judges (mean = 88%), with cor responding Kappa values ranging from 0.46 to 0.85 (mean = 0.69). Diari es, capsule counts, and spectrofluorimetric data were used to validate judges' ratings in four trials, including one in which subjects were alcohol-dependent participants in one of three pharmacotherapy trials, Rating accuracy was influenced by dosage, time interval between inges tion and urine collection, and previous dosing, Overall, ratings tende d to be accurate, with incorrect judgments limited to specimens with l ow concentrations of urinary riboflavin. The results indicate that ult raviolet light detection of urinary riboflavin is a useful method for the assessment of patient compliance with medication regimens, includi ng compliance of patients assigned to receive placebo in clinical tria ls of medications for alcoholism treatment.