Contingency Management for Alcohol Use Disorders

酒精使用障碍的应急管理

基本信息

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
项目类别：
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

项目摘要

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）治疗对于改善药物滥用患者的治疗效果非常有效。然而，CM 很少应用于患有酒精使用障碍的个体，主要是因为监测饮酒方面的技术限制。安全连续远程酒精监测仪 (SCRAMx(R)) 是一项新技术，旨在每周 7 天、每天 24 小时连续监测酒精消耗量。该系统可能非常适合酒精使用障碍患者的 CM 试验。本研究的目的是评估 CM 使用 SCRAMx 减少饮酒的功效。总共 120 名在社区诊所开始门诊治疗的酗酒或受抚养患者将被随机分配到以下两种情况之一：标准护理，或标准护理加基于 SCRAMx 读数结果强化的 CM。研究干预将持续 12 周，在基线、治疗后和一年的随访期间进行评估。所有参与者将在 12 周的研究期间佩戴 SCRAMx 监测器，作为饮酒的客观指标，并在随访时再次佩戴。与标准护理相比，我们预计 CM 将减少饮酒天数和延长连续不饮酒天数。我们还将评估 CM 对酒精结果的长期影响，并且我们假设治疗期间长期不饮酒将导致整个后续期间饮酒率降低。此外，我们将探讨冲动与治疗结果的关系，以及冲动是否会缓和或介导饮酒结果。 CM 还有望减少其他药物使用和艾滋病毒危险行为，这些行为与饮酒密切相关。最后，我们将评估 CM 的成本效益和潜在成本效益。尽管这种治疗明显增加了成本，但它在减少饮酒方面可能比标准治疗更具成本效益，并且本研究将估计这种治疗可能具有成本效益的条件和患者群体。这项研究的结果对于将 CM 纳入酒精使用障碍的治疗以及在临床试验中利用这项新技术铺平道路非常重要。