Zhang Xiaoni, Hardcastle Valerie
Department of Management, Information Systems and Quantitative Methods, The University of Alabama at Birmingham, CSB 371 710 13th Street South, Birmingham, AL, 35294, United States, 1 2059348890, 1 2059348830.
Institute for Health Innovation, Northern Kentucky University, Highland Heights, KY, 41099, USA.
JMIR Ment Health. 2025 Sep 2;12:e73617. doi: 10.2196/73617.
Although contingency management has shown some efficacy in substance use disorder treatment, digital contingency management (DCM) needs more evidence supporting its value in treating substance misuse.
This study aimed to evaluate the effectiveness of DCM in treating substance use disorder by examining 2 key outcome variables-abstinence and appointment attendance.
A 12-month quasi-experimental design was conducted by enrolling patients into 2 groups using an alternating assignment process: one group receiving treatment-as-usual plus DCM and the other receiving treatment as usual with no contingency management. Propensity score matching was conducted to match groups on covariates. After matching, t tests were conducted to examine the difference between groups on urine abstinence and appointment attendance rates.
Two cohorts of propensity-matched patients (66 interventions and 59 controls) were analyzed. Abstinence was significantly higher in the DCM group (mean 0.92, 95% CI 0.88-0.96) than in the treatment-as-usual group (mean 0.85, 95% CI 0.79-0.90; P<.01). Appointment attendance also demonstrated significant differences between the groups, with the DCM group achieving a mean rate of 0.69 (95% CI 0.65-0.74) compared with 0.50 (95% CI 0.45-0.55) in the treatment-as-usual group (P<.001). This notable increase highlights the role of DCM in fostering engagement with care, an essential factor for successful treatment outcomes.
The results suggest that DCM can be an effective treatment modality for substance use disorder.
尽管应急管理在物质使用障碍治疗中已显示出一定疗效，但数字应急管理（DCM）在治疗物质滥用方面的价值还需要更多证据支持。
本研究旨在通过检查两个关键结果变量——戒断和预约出席情况，评估DCM在治疗物质使用障碍中的有效性。
采用12个月的准实验设计，通过交替分配过程将患者分为两组：一组接受常规治疗加DCM，另一组接受常规治疗但无应急管理。进行倾向得分匹配以在协变量上匹配两组。匹配后，进行t检验以检查两组在尿液戒断率和预约出席率上的差异。
分析了两组倾向得分匹配的患者（66例干预组和59例对照组）。DCM组的戒断率（均值0.92，95%CI 0.88 - 0.96）显著高于常规治疗组（均值0.85，95%CI 0.79 - 0.90；P <.01）。两组在预约出席率上也存在显著差异，DCM组的平均出席率为0.69（95%CI 0.65 - 0.74），而常规治疗组为0.50（95%CI 0.45 - 0.55）（P <.001）。这一显著提高凸显了DCM在促进接受治疗方面的作用，这是成功治疗结果的一个关键因素。
结果表明DCM可能是治疗物质使用障碍的一种有效治疗方式。
