Digital Contingency Management for Substance Use Disorder Treatment: 12-Month Quasi-Experimental Design.

Background: Although contingency management 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 aimed to evaluate the effectiveness of DCM in treating substance use disorder by examining 2 key outcome variables-abstinence and appointment attendance.

Methods: A 12-month quasi-experimental design was conducted by enrolling patients into 2 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 DCM 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<.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 with 0.50 (95% CI 0.45-0.55) in the treatment-as-usual group (P<.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.