Benishek Lois A, Dugosh Karen L, Kirby Kim C, Matejkowski Jason, Clements Nicolle T, Seymour Brittany L, Festinger David S
Treatment Research Institute, Philadelphia, PA, USA; University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA.
Addiction. 2014 Sep;109(9):1426-36. doi: 10.1111/add.12589. Epub 2014 May 23.
To review randomized controlled trials to assess efficacy of a prize-based contingency management procedure in reducing substance use (where a drug-free breath or urine sample provides a chance of winning a prize).
A meta-analysis was conducted on papers published from January 2000 to February 2013 to determine the effect size of studies comparing prize-based contingency management to a treatment-as-usual control condition (k = 19 studies). Parallel analyses evaluated the efficacy of both short- (k = nine studies) and long-term outcomes (k = six studies) of prize-based contingency management.
The average end-of-treatment effect size (Cohen's d) was 0.46 [95% confidence interval (CI) = 0.37, 0.54]. This effect size decreased at the short-term (≤3-month) post-intervention follow-up to 0.33 (95% CI = 0.12, 0.54) and at the 6-month follow-up time-point there was no detectable effect [d = -0.09 (95% CI = -0.28, 0.10)].
Adding prize-based contingency management to behavioral support for substance use disorders can increase short-term abstinence, but the effect does not appear to persist to 6 months.
回顾随机对照试验，以评估基于奖励的应急管理程序在减少物质使用方面的疗效（无毒品的呼吸或尿液样本提供赢得奖励的机会）。
对2000年1月至2013年2月发表的论文进行荟萃分析，以确定将基于奖励的应急管理与常规治疗对照条件进行比较的研究的效应大小（k = 19项研究）。平行分析评估了基于奖励的应急管理的短期（k = 9项研究）和长期结果（k = 6项研究）的疗效。
治疗结束时的平均效应大小（科恩d值）为0.46 [95%置信区间（CI）= 0.37, 0.54]。在干预后短期（≤3个月）随访时，该效应大小降至0.33（95% CI = 0.12, 0.54），在6个月随访时间点没有可检测到的效应 [d = -0.09（95% CI = -0.28, 0.10）]。
在对物质使用障碍的行为支持中加入基于奖励的应急管理可以增加短期戒酒，但这种效果似乎不会持续到6个月。
