Accepted for/Published in: JMIR Mental Health
Date Submitted: Mar 7, 2025
Open Peer Review Period: Jun 2, 2025 - Jul 28, 2025
Date Accepted: Jun 7, 2025
(closed for review but you can still tweet)
Digital Contingency Management for Substance Use Disorder Treatment: A 12-Month Quasi-Experimental Design
ABSTRACT
Background:
Although contingency management (CM) 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 aims to evaluate the effectiveness of DCM in treating substance use disorder by examining two key outcome variables: abstinence and appointment attendance.
Methods:
A 12-month quasi-experimental design was conducted by enrolling patients into two 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 digital contingency management 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-value < .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 to 0.50 (95% CI: 0.45–0.55) in the TAU group (P-value < .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.
Citation
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