A smartphone-smartcard platform for contingency management in an inner-city substance use disorder outpatient program

DeFulio, Anthony; Rzeszutek, Mark J.; Furgeson, Josh; Ryan, Shawn A.; Rezania, Samin

doi:10.1016/j.jsat.2020.108188

Cited by 25 publications

(19 citation statements)

References 26 publications

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“…The present study is also consistent with a larger trend of using mobile devices to implement contingency management procedures ( DeFulio et al, 2021 , Kurti et al, 2016 , Moore et al, 2015 ). This approach to implementation offers several advantages that should greatly facilitate adoption of contingency management interventions for health behaviors.…”

Section: Discussionsupporting

confidence: 90%

Smartphone-based incentives for promoting adherence to antiretroviral therapy: A randomized controlled trial

DeFulio

Devoto

Traxler

et al. 2021

Preventive Medicine Reports

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Section: Discussionsupporting

confidence: 90%

Smartphone-based incentives for promoting adherence to antiretroviral therapy: A randomized controlled trial

DeFulio

Devoto

Traxler

et al. 2021

Preventive Medicine Reports

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“…The present study shows that contingency management delivered via a smartphone-smartcard platform can improve drug use and clinic attendance outcomes among patients with concurrent opioid and stimulant use disorders when used as an adjunct to care in an outpatient buprenorphine maintenance program. The present finding is broadly consistent with prior contingency management studies in general ( 3 – 5 ), and with prior studies of the same smartphone-smartcard platform for delivery contingency management intervention ( 6 – 8 ). This is a timely finding, as the Office of National Drug Control Policy (ONDCP) top priority for 2021 is, “Expanding access to evidence-based treatment”, and specific actions described by the ONDCP toward this end include, “Identify and address policy barriers related to contingency management interventions (motivational incentives) for stimulant use disorder”, and “Explore reimbursement for motivational incentives and digital treatment for addiction, especially stimulant use disorder” ( 9 ).…”

Section: Discussionsupporting

confidence: 91%

“…This study involved the pilot implementation of a smartphone-smartcard platform developed by DynamiCare Health, Inc. (Boston, MA) described in detail elsewhere ( 8 ). The contingency management intervention provided appointment reminders with smartphone GPS monitoring, cognitive behavioral therapy readings with exercises and comprehension questions, and up to $100 per month in monetary incentives for these and for abstinent substance tests.…”

Section: Methodsmentioning

confidence: 99%

“…Save for costs, these barriers are wholly obviated by delivering the intervention via a smartphone-smartcard platform that automates all aspects of intervention management. This delivery system for contingency management intervention has been shown to be effective in promoting smoking cessation ( 6 ), alcohol abstinence ( 7 ), and in promoting drug abstinence and clinic attendance in people receiving outpatient treatment for opioid use disorder at an inner-city clinic ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

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A Smartphone-Smartcard Platform for Implementing Contingency Management in Buprenorphine Maintenance Patients With Concurrent Stimulant Use Disorder

et al. 2021

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Background and Objectives: Opioid agonist pharmacotherapies are effective in the treatment of opioid use disorder (OUD) but concurrent stimulant use is common and can lead to relapse and treatment drop out. Contingency management in combination with opioid agonist pharmacotherapy has broad beneficial effects in polysubstance users, including promoting drug abstinence and treatment retention, but clinic-based implementation can be burdensome. The present study was conducted to evaluate a contingency management intervention delivered via a smartphone-smartcard platform in OUD patients who had concurrent stimulant use disorder.Methods: Retrospective comparison of (n = 124) patients; half received the contingency management intervention and half were matched controls. Drug use and clinic attendance outcomes over four consecutive 30-day periods were analyzed with regression.Results: The intervention group showed consistently higher rates of drug abstinence and clinic attendance which were significant at the latter two timepoints.Discussion: Smartphone-smartcard platforms can facilitate dissemination of contingency management by surmounting or obviating key barriers to adoption. They appear to be convenient for all stakeholders, are easy to use, and facilitate high-fidelity implementation. Delivering contingency management via a smartphone-smartcard platform produces effects consistent with those observed when the intervention is delivered with substantially costlier and more burdensome in-person procedures.

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“…Technology might optimise the application of reinforcement principles, monitoring and reinforcing the target behaviour more frequently than is otherwise possible [22,24]. A meta-analysis of mobile telephone-delivered CM [25] and more recent evaluation studies [19,[26][27][28][29][30] suggest these interventions are effective in generating positive behaviour change. However, the platforms upon which these interventions can be implemented might vary in their appropriateness or acceptability to the patient population.…”

Section: Introductionmentioning

confidence: 99%

Patients' beliefs towards contingency management: Target behaviours, incentives and the remote application of these interventions

Getty

Weaver

Lynskey

et al. 2021

Drug and Alcohol Review

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Introduction. Contingency management interventions are among the most efficacious psychosocial interventions in promoting abstinence from smoking, alcohol and substance use. The aim of this study was to assess the beliefs and objections towards contingency management among patients in UK-based drug and alcohol services to help understand barriers to uptake and support the development and implementation of these interventions. Methods. The Service User Survey of Incentives was developed and implemented among patients (N = 181) at three UK-based drug and alcohol treatment services. Descriptive analyses were conducted to ascertain positive and negative beliefs about contingency management, acceptability of different target behaviours, incentives and delivery mechanisms including delivering incentives remotely using technology devices such as mobile telephones. Results. Overall, 81% of participants were in favour of incentive programs, with more than 70% of respondents agreeing with the majority of positive belief statements. With the exception of two survey items, less than a third of participants agreed with negative belief statements. The proportion of participants indicating a neutral response was higher for negative statements (27%) indicating greater levels of ambiguity towards objections and concerns regarding contingency management. Discussion and Conclusions. Positive beliefs towards contingency management interventions were found, including high levels of acceptability towards a range of target behaviours, incentives and the use of technology devices to remotely monitor behaviour and deliver incentives. These findings have implications for the development and implementation of remote contingency management interventions within the UK drug treatment services.

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A smartphone-smartcard platform for contingency management in an inner-city substance use disorder outpatient program

Cited by 25 publications

References 26 publications

Smartphone-based incentives for promoting adherence to antiretroviral therapy: A randomized controlled trial

Smartphone-based incentives for promoting adherence to antiretroviral therapy: A randomized controlled trial

A Smartphone-Smartcard Platform for Implementing Contingency Management in Buprenorphine Maintenance Patients With Concurrent Stimulant Use Disorder

Patients' beliefs towards contingency management: Target behaviours, incentives and the remote application of these interventions

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