Digital Contingency Management for Substance Use Disorder Treatment: A 12-Month Quasi-Experimental Design (Preprint)

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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. CLINICALTRIAL

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