Contingency Management for Alcohol Use Disorders

酒精使用障碍的应急管理

• 批准号: 8489773
• 负责人: NANCY M PETRY
• 金额: $ 71.88万
• 依托单位: UNIVERSITY OF CONNECTICUT SCH OF MED/DNT
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-07-15 至 2017-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8489773
• 关键词: Abstinence; Address; Aftercare; Alcohol abuse; Alcohol consumption; Alcohol dependence; Alcohols; Clinic; Clinical Treatment; Clinical Trials; Communicable Diseases; Communities; Costs and Benefits; Data; Decision Making; Devices; Drug usage; Environment; Future; HIV risk; Hour; Impulsivity; Individual; Internet; Intervention Studies; Lead; Link; Long-Term Effects; Measures; Mediating; Monitor; Nature; Outcome; Outpatients; Participant; Patient Self-Report; Patients; Policies; Prize; Probability; Psychological reinforcement; Randomized; Reading; Research; Resources; Risk Behaviors; Role; Secure; Sex Behavior; Subgroup; Substance Use Disorder; System; Technology; Telephone; Toxicology; Treatment outcome; Wireless Technology; alcohol abstinence; alcohol monitoring; alcohol research; alcohol use disorder; base; contingency management; cost; cost effective; cost effectiveness; data exchange; design; discounting; drinking; follow-up; high risk behavior; improved; new technology; patient population; public health relevance; reduced alcohol use; secondary outcome; standard care; substance abuse treatment; treatment duration

DESCRIPTION (provided by applicant): Contingency management (CM) treatments are highly efficacious in improving outcomes of substance abusing patients. However, CM has rarely been applied to individuals with alcohol use disorders, primarily because of technological limitations in monitoring drinking. The Secure Continuous Remote Alcohol Monitor (SCRAMx(R)) is a new technology designed to continuously monitor alcohol consumption 24 hours a day for 7 days per week. This system may be ideal for use in CM trials with patients with alcohol use disorders. The purpose of this study is to evaluate the efficacy of CM in reducing alcohol use using SCRAMx. In total, 120 alcohol abusing or dependent patients initiating outpatient treatment at community-based clinics will be randomly assigned to one of two conditions: standard care, or standard care plus CM with reinforcement based on results of SCRAMx readings. Study interventions will last for 12 weeks, with assessments conducted at baseline, post-treatment and throughout a one-year follow-up. All participants will wear SCRAMx monitors throughout the 12-week study period as an objective indicator of alcohol use, and again at follow-up. Compared with standard care, we expect that CM will result in fewer drinking days and longer durations of continuous non-drinking days. We will evaluate the long-term effects of CM on alcohol outcomes as well, and we hypothesize that long durations of non-drinking during the treatment period will result in lower rates of drinking throughout the follow-u period. In addition, we will explore the association of impulsivity with treatment outcomes, and whether impulsivity moderates or mediates drinking outcomes. CM is also expected to reduce other drug use and HIV risk behaviors, which are intricately linked with alcohol use. Finally, we will assess the cost-effectiveness and potential cost-benefits of CM. Although this treatment clearly adds costs, it may be more cost-effective in reducing drinking than standard care, and this study will estimate the conditions under which and patient populations for whom it may be cost effective. Results from this study will be important for paving the way toward integrating CM into treatment for alcohol use disorders and for utilizing this new technology in clinical trials.

描述（由申请人提供）：应急管理（CM）治疗在改善滥用药物的患者的结局方面非常有效。但是，CM很少应用于患有饮酒障碍的人，这主要是由于监测饮酒的技术限制。安全的连续远程酒精监护仪（SCRAMX（R））是一项新技术，旨在每天24小时连续监测酒精消耗，每周7天。该系统可能非常适合与酒精使用障碍患者进行CM试验。这项研究的目的是评估CM使用SCRAMX降低酒精含量的功效。根据Scramx读数的结果，总共将有120名滥用酒精或依赖的患者随机分配给两个条件之一：标准护理或标准护理加上CM，并加强CM。研究干预措施将持续12周，并在基线，治疗后以及整个一年的随访中进行评估。所有参与者将在整个12周的研究期间都穿着SCRAMX监视器，作为酒精使用的客观指标，并在随访中再次进行。与标准护理相比，我们预计CM会导致饮酒天数较少，并且持续不喝酒的日子的持续时间更长。我们还将评估CM对酒精预后的长期影响，我们假设在治疗期间长期不喝酒的持续时间将导致在随后的U期间饮酒率较低。此外，我们将探讨冲动性与治疗结果的关联，以及冲动性是否适中或调解饮酒结果。 CM还有望减少其他药物使用和艾滋病毒风险行为，这与饮酒无关。最后，我们将评估CM的成本效益和潜在的成本效益。尽管这种治疗方法显然增加了成本，但它在减少饮酒方面可能比标准护理更具成本效益，这项研究将估计其具有成本效益的患者人群和患者人群的状况。这项研究的结果对于铺平了将CM整合到酒精使用障碍治疗以及在临床试验中利用这项新技术的方法很重要。