Increasing MAT Engagement With Financial Incentives
- Conditions
- Opioid-use Disorder
- Interventions
- Behavioral: Contingency management
- Registration Number
- NCT04585399
- Lead Sponsor
- Rowan University
- Brief Summary
The increased prevalence of opioid use disorder (OUD) and associated overdoses and adverse events has led to a substantial increase in the number of patients being seen at emergency departments (ED). Thus, the ED may be an ideal location for identifying patients in need of OUD treatment and can serve as the first touch point in the OUD continuum of care to promote medication assisted treatment initiation. Contingency management (CM) is an effective method for promoting treatment initiation and adherence that has not been thoroughly evaluated for this purpose. The primary aim of the current study is to develop and assess the effectiveness, acceptability, and feasibility of a protocol for delivering CM to increase combined buprenorphine + nalaxone (referred to as BUP hereafter) initiation and continuous adherence for OUD in an existing ED "bridge" program (e.g., Bridge plus CM; B+CM) relative to standard care. Secondary objectives include identifying behavioral and neuropsychological correlates to treatment outcomes, including delay discounting, reinforcer demand, and neurological soft signs.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 92
- Participants at least 18 years of age
- Participants must be newly enrolled in the Bridge program in the Cooper University ED, with their first clinic appointment scheduled to take place at the Cooper Outreach Clinic within one week of enrollment.
- All subjects must be in good physical health as determined by a physical examination and premenopausal women will have a pregnancy test on the day of the study to rule out pregnancy
- Participants who demonstrate contraindication with Suboxone treatment or who are currently or have recently used other medication-assisted therapies for opioid use disorder.
- Participants who are currently pregnant or breastfeeding or have been diagnosed with a DSM-5 psychiatric condition that might interfere with treatment delivery (e.g., uncontrolled schizophrenia, bipolar disorder, dementia)
- Participants who are non-English speaking or cannot otherwise provide valid informed consent.
- Individuals who are unable to complete the survey assessments, due to literacy or visual impairments.
- The participant will not be a prisoner
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Contingency Management Contingency management Participants in this arm of the study will receive financial incentives for attending their buprenorphine appointments and for being clean from other opioids. Participants in this group will also have up to two rides per week paid for to attend bup appointments.
- Primary Outcome Measures
Name Time Method Percentage of sessions where buprenorphine positive urine results was recorded 3-months Urine-verified buprenorphine
Percentage of sessions where opioid free urine results were recorded 3-months Urine-verified opioid abstinence
Treatment acceptability 3-months Participants will evaluate the treatment at the end.
Attendance at first scheduled clinic appointment 1 week We will track attendance at participant's first scheduled BUP appointment after being bridged from the ED
- Secondary Outcome Measures
Name Time Method Opioid demand as a correlate of opioid-free urine test results and buprenorphine-positive results 3-months The opioid purchasing task will be used to evaluate opioid demand and will be correlated with urine results determining opioid abstinence and buprenorphine adherence.
Delay discounting as a correlate of opioid-free urine test results and buprenorphine-positive results 3-months Delay discounting will be evaluated, using the brief, five question delay discounting procedure and will be correlated with urine results determining opioid abstinence and buprenorphine adherence.
Substance-free activities as a correlate of opioid-free urine test results and buprenorphine-positive results 3-months A modified Pleasant Events Scale survey will be used to evaluate access to, and enjoyment from, substance-free activities and the results will be correlated with urine results determining opioid abstinence and buprenorphine adherence.
Neurological Soft Signs correlate with treatment success 3-months Participants will complete a drawing task that has been correlated with other substance use treatment outcomes in the past.
Trial Locations
- Locations (1)
Cooper University Hospital
🇺🇸Camden, New Jersey, United States