A randomized trial of contingency management reinforcing attendance at treatment: Do duration and timing of reinforcement matter?
A randomized trial of contingency management reinforcing attendance at treatment: Do duration and timing of reinforcement matter?
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DOI：
10.1037/ccp0000330
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发表时间：
2018-10
影响因子：
5.9
通讯作者：
Carroll KM
中科院分区：
文献类型：
--
作者：
Petry NM;Alessi SM;Rash CJ;Barry D;Carroll KM
加强出勤的应急管理(CM)干预措施很少从减少药物使用的角度进行评估。使用序贯随机设计，本研究检验了三种就诊CM条件与常规护理(UC)对药物使用结果的影响。它评估了CM交付的持续时间(6周与12周)和时机(早期与晚期治疗)是否影响治疗反应。方法：360例可卡因使用障碍患者在开始门诊治疗后，随机分为UC组和CM组，分别接受为期6周的治疗。在第6周，患者(n=308)被重新随机分配到UC或CM，继续6周，根据当前功能进行分层分配。每周两次对样本进行非法药物筛查，为期12周。结果：在两个时间点随机服用CM的患者比从未随机服用CM的患者参加的疗程更多，戒烟效果更好。相对于UC，只在第1-6周接受出勤CM并不有效，但在第7-12周接受出勤CM的人与从未接受CM的人相比只有一些好处。12周的CM比6周的CM更有效。在随访中，两组之间在药物使用方面没有发现差异，但接受治疗的天数和治疗期间阴性样本的比例与长期戒断可卡因有关。结论：以出诊为基础的CM增加了治疗参与度并减少了药物使用，当CM在较长的持续时间内和在门诊护理的后期阶段使用时，注意到了有益的效果。
Contingency management (CM) interventions that reinforce attendance have rarely been evaluated in terms of reducing drug use. Using a sequential randomized design, this study examined the efficacy of three attendance CM conditions compared to usual care (UC) on drug use outcomes. It evaluated whether the duration (6 versus 12 weeks) and timing (early versus later treatment) of CM delivery impact treatment response. Method: Upon initiating outpatient treatment, patients with cocaine use disorders (N = 360) were randomized to UC or CM for attending treatment for 6 weeks. At week 6, patients (n = 308) were re-randomized to UC or CM for another 6 weeks, with assignment stratified on current functioning. Samples were screened for illicit drugs twice weekly for 12 weeks. Results: Patients randomized to CM at both time- points attended more sessions and achieved more abstinence than those never randomized to CM. Relative to UC, receiving attendance CM in weeks 1–6 only was not efficacious, but those receiving attendance CM in weeks 7–12 only evidenced some benefits compared to those who never received CM. Twelve weeks of attendance CM was more efficacious than six weeks. No between-group differences in drug use were noted at follow-ups, but days attended treatment and proportion negative samples during treatment were associated with long-term cocaine abstinence. Conclusions: Attendance-based CM increases treatment participation and reduces drug use, with beneficial effects noted when CM is delivered over longer durations and during later phases of outpatient care.
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影响因子：
2.3
作者：
Alessi, Sheila M.;Hanson, Tressa;Petry, Nancy M.
通讯作者：
Petry, Nancy M.
影响因子：
4.2
作者：
Olmstead, Todd A.;Sindelar, Jody L.;Petry, Nancy A.
通讯作者：
Petry, Nancy A.
影响因子：
1.9
作者：
KOSTEN, TR;ROUNSAVILLE, BJ;KLEBER, HD
通讯作者：
KLEBER, HD
影响因子：
6
作者：
Higgins, Stephen T.;Heil, Sarah H.;Badger, Gary J.
通讯作者：
Badger, Gary J.
影响因子：
4.2
作者：
DePhilippis, Dominick;Petry, Nancy M.;McKay, James R.
通讯作者：
McKay, James R.