Prize-based contingency management for the treatment of substance abusers: a meta-analysis

被引:177
作者
Benishek, Lois A. [1 ,2 ]
Dugosh, Karen L. [1 ]
Kirby, Kim C. [1 ,2 ]
Matejkowski, Jason [1 ,3 ]
Clements, Nicolle T. [1 ,4 ]
Seymour, Brittany L. [1 ]
Festinger, David S. [1 ,2 ]
机构
[1] Treatment Res Inst, Philadelphia, PA 19106 USA
[2] Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA
[3] Univ Kansas, Sch Social Welf, Lawrence, KS 66045 USA
[4] St Josephs Univ, Dept Decis Syst Sci, Philadelphia, PA 19131 USA
关键词
Contingency management; incentives; meta-analysis; prize-based; substance abuse treatment; substance use disorder; METHADONE-MAINTENANCE TREATMENT; RANDOMIZED-TRIAL; COCAINE USE; DRUG-ABUSE; MEDICATION ADHERENCE; SYSTEMATIC REVIEWS; OPIATE ABSTINENCE; METHOD GUIDELINES; AFRICAN-AMERICAN; CONTINUING CARE;
D O I
10.1111/add.12589
中图分类号
R194 [卫生标准、卫生检查、医药管理];
学科分类号
摘要
Aim 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). Methods 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. Results 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)]. Conclusion 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.
引用
收藏
页码:1426 / 1436
页数:11
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