Digital Contingency Management for Substance Use Disorder Treatment: 12-Month Quasi-Experimental Design.

BACKGROUND

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.

OBJECTIVE

This study aimed to evaluate the effectiveness of DCM in treating substance use disorder by examining 2 key outcome variables-abstinence and appointment attendance.

METHODS

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.

RESULTS

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.

CONCLUSIONS

The results suggest that DCM can be an effective treatment modality for substance use disorder.