Trial Outcomes & Findings for Extending Long-term Outcomes Through an Adaptive Aftercare Intervention (NCT NCT02143063)

NCT ID: NCT02143063

Last Updated: 2022-01-13

Results Overview

Longest duration of consecutive cocaine-negative urine toxicology tests

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

274 participants

Primary outcome timeframe

baseline through 6 months

Results posted on

2022-01-13

Participant Flow

Participant milestones

Participant milestones
Measure
Standard Care (SC)
Standard care IOP treatment for cocaine use disorder. In addition, SC participants submitted urine samples during the 24-week intervention phase. Patients selected two days a week on which drug screens might occur (e.g., M/Th, T/F). On the morning of each potential drug screen day, research staff texted participants to indicate if a sample was due. In weeks 1-3, urine screens occurred on two days per week. In weeks 4-9, screens occurred on one randomly selected day each week. In weeks 10-24, drug screens occurred once every 2-3 weeks on average. After a missed sample, the next two screen days were prompted for sample submission. An algorithm developed in-house was used to generate and monitor the drug screen schedule. Participants received $2 per requested sample submitted plus a $20 bonus for submitting all requested samples in a 4-week period. The goal was to result in 18 samples on average, equivalent relative to the new SC plus variable interval CM condition.
Standard Care Plus Traditional Contingency Management
Standard care plus "standard" prize contingency management twice weekly for urine screens indicating cocaine abstinence. Urine screens occurred on the same monitoring schedule described for the SC condition, including $2 per requested sample submitted and a $20 bonus for all requested samples in a 4-week period. In addition, participants received chances for prizes on a escalating reinforcement schedule and with a reset condition for unexcused missed samples. Mean maximum earnings for cocaine-negative urine screens was $460 in prizes.
Standard Care Plus Variable Interval Contingency Management
Standard care plus prize contingency management on a variable interval schedule for cocaine abstinence. Relative to the traditional CM condition, in this condition, the frequency of samples to earn reinforcement decreased over time contingent on achieving periods of sustained abstinence. The schedule was designed to result in an average of at least 18 urine samples over 24 weeks among participants maintaining abstinence. Participants received the sample compensation for submitted urine samples regardless of results as in the other two conditions.
Overall Study
STARTED
61
105
108
Overall Study
COMPLETED
45
75
78
Overall Study
NOT COMPLETED
16
30
30

Reasons for withdrawal

Reasons for withdrawal
Measure
Standard Care (SC)
Standard care IOP treatment for cocaine use disorder. In addition, SC participants submitted urine samples during the 24-week intervention phase. Patients selected two days a week on which drug screens might occur (e.g., M/Th, T/F). On the morning of each potential drug screen day, research staff texted participants to indicate if a sample was due. In weeks 1-3, urine screens occurred on two days per week. In weeks 4-9, screens occurred on one randomly selected day each week. In weeks 10-24, drug screens occurred once every 2-3 weeks on average. After a missed sample, the next two screen days were prompted for sample submission. An algorithm developed in-house was used to generate and monitor the drug screen schedule. Participants received $2 per requested sample submitted plus a $20 bonus for submitting all requested samples in a 4-week period. The goal was to result in 18 samples on average, equivalent relative to the new SC plus variable interval CM condition.
Standard Care Plus Traditional Contingency Management
Standard care plus "standard" prize contingency management twice weekly for urine screens indicating cocaine abstinence. Urine screens occurred on the same monitoring schedule described for the SC condition, including $2 per requested sample submitted and a $20 bonus for all requested samples in a 4-week period. In addition, participants received chances for prizes on a escalating reinforcement schedule and with a reset condition for unexcused missed samples. Mean maximum earnings for cocaine-negative urine screens was $460 in prizes.
Standard Care Plus Variable Interval Contingency Management
Standard care plus prize contingency management on a variable interval schedule for cocaine abstinence. Relative to the traditional CM condition, in this condition, the frequency of samples to earn reinforcement decreased over time contingent on achieving periods of sustained abstinence. The schedule was designed to result in an average of at least 18 urine samples over 24 weeks among participants maintaining abstinence. Participants received the sample compensation for submitted urine samples regardless of results as in the other two conditions.
Overall Study
Lost to Follow-up
16
28
29
Overall Study
Withdrawal by Subject
0
1
0
Overall Study
Death
0
1
1

Baseline Characteristics

Extending Long-term Outcomes Through an Adaptive Aftercare Intervention

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Standard Care
n=61 Participants
standard care standard care
Standard Care Plus Traditional Contingency Managment
n=105 Participants
prize contingency management on a traditional twice weekly schedule for cocaine abstinence prize contingency management on a traditional twice weekly schedule for cocaine abstinence standard care
Standard Care Plus Variable Interval Contingency Management
n=108 Participants
prize contingency management on a variable interval schedule for cocaine abstinence prize contingency management on a variable interval schedule for cocaine abstinence standard care
Total
n=274 Participants
Total of all reporting groups
Age, Continuous
39.9 years
STANDARD_DEVIATION 9.2 • n=5 Participants
40.7 years
STANDARD_DEVIATION 9.6 • n=7 Participants
39.7 years
STANDARD_DEVIATION 10.1 • n=5 Participants
40.1 years
STANDARD_DEVIATION 9.7 • n=4 Participants
Sex: Female, Male
Female
32 Participants
n=5 Participants
57 Participants
n=7 Participants
58 Participants
n=5 Participants
147 Participants
n=4 Participants
Sex: Female, Male
Male
29 Participants
n=5 Participants
48 Participants
n=7 Participants
50 Participants
n=5 Participants
127 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
14 Participants
n=5 Participants
23 Participants
n=7 Participants
27 Participants
n=5 Participants
64 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
47 Participants
n=5 Participants
81 Participants
n=7 Participants
81 Participants
n=5 Participants
209 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
1 Participants
n=7 Participants
0 Participants
n=5 Participants
1 Participants
n=4 Participants
Race (NIH/OMB)
American Indian or Alaska Native
1 Participants
n=5 Participants
2 Participants
n=7 Participants
0 Participants
n=5 Participants
3 Participants
n=4 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Black or African American
16 Participants
n=5 Participants
35 Participants
n=7 Participants
30 Participants
n=5 Participants
81 Participants
n=4 Participants
Race (NIH/OMB)
White
33 Participants
n=5 Participants
52 Participants
n=7 Participants
64 Participants
n=5 Participants
149 Participants
n=4 Participants
Race (NIH/OMB)
More than one race
5 Participants
n=5 Participants
4 Participants
n=7 Participants
6 Participants
n=5 Participants
15 Participants
n=4 Participants
Race (NIH/OMB)
Unknown or Not Reported
6 Participants
n=5 Participants
12 Participants
n=7 Participants
8 Participants
n=5 Participants
26 Participants
n=4 Participants
Region of Enrollment
United States
61 participants
n=5 Participants
105 participants
n=7 Participants
108 participants
n=5 Participants
274 participants
n=4 Participants

PRIMARY outcome

Timeframe: baseline through 6 months

Longest duration of consecutive cocaine-negative urine toxicology tests

Outcome measures

Outcome measures
Measure
Standard Care Plus Traditional Contingency Managment
n=104 Participants
prize contingency management on a traditional twice weekly schedule for cocaine abstinence prize contingency management on a traditional twice weekly schedule for cocaine abstinence standard care
Standard Care Plus Variable Interval Contingency Management
n=104 Participants
prize contingency management on a variable interval schedule for cocaine abstinence prize contingency management on a variable interval schedule for cocaine abstinence standard care
Standard Care
n=58 Participants
standard care standard care
Longest Duration of Abstinence From Cocaine
6.64 weeks
Interval 2.79 to 13.57
6.93 weeks
Interval 2.14 to 12.57
4.14 weeks
Interval 1.14 to 8.86

SECONDARY outcome

Timeframe: baseline through 6 months

Based on breath and urine toxicology tests (alcohol, methamphetamine, cocaine, opioids, THC, amphetamine, benzodiazepines)

Outcome measures

Outcome measures
Measure
Standard Care Plus Traditional Contingency Managment
n=104 Participants
prize contingency management on a traditional twice weekly schedule for cocaine abstinence prize contingency management on a traditional twice weekly schedule for cocaine abstinence standard care
Standard Care Plus Variable Interval Contingency Management
n=104 Participants
prize contingency management on a variable interval schedule for cocaine abstinence prize contingency management on a variable interval schedule for cocaine abstinence standard care
Standard Care
n=58 Participants
standard care standard care
Longest Duration of Abstinence From All Substances Tested
5.93 weeks
Interval 1.57 to 12.64
5.71 weeks
Interval 1.57 to 11.64
4.75 weeks
Interval 0.68 to 8.04

Adverse Events

Standard Care

Serious events: 46 serious events
Other events: 12 other events
Deaths: 0 deaths

Standard Care Plus Traditional Contingency Managment

Serious events: 66 serious events
Other events: 7 other events
Deaths: 1 deaths

Standard Care Plus Variable Interval Contingency Management

Serious events: 77 serious events
Other events: 9 other events
Deaths: 1 deaths

Serious adverse events

Serious adverse events
Measure
Standard Care
n=61 participants at risk
standard care standard care
Standard Care Plus Traditional Contingency Managment
n=105 participants at risk
prize contingency management on a traditional twice weekly schedule for cocaine abstinence prize contingency management on a traditional twice weekly schedule for cocaine abstinence standard care
Standard Care Plus Variable Interval Contingency Management
n=108 participants at risk
prize contingency management on a variable interval schedule for cocaine abstinence prize contingency management on a variable interval schedule for cocaine abstinence standard care
Social circumstances
Inpatient substance use treatment
44.3%
27/61 • Number of events 58 • 18 months
38.1%
40/105 • Number of events 59 • 18 months
43.5%
47/108 • Number of events 66 • 18 months
Psychiatric disorders
Inpatient psychiatric treatment
14.8%
9/61 • Number of events 18 • 18 months
4.8%
5/105 • Number of events 7 • 18 months
11.1%
12/108 • Number of events 16 • 18 months
General disorders
Inpatient medical treatment
19.7%
12/61 • Number of events 19 • 18 months
19.0%
20/105 • Number of events 28 • 18 months
16.7%
18/108 • Number of events 25 • 18 months
General disorders
Death
0.00%
0/61 • 18 months
0.95%
1/105 • Number of events 1 • 18 months
0.93%
1/108 • Number of events 1 • 18 months

Other adverse events

Other adverse events
Measure
Standard Care
n=61 participants at risk
standard care standard care
Standard Care Plus Traditional Contingency Managment
n=105 participants at risk
prize contingency management on a traditional twice weekly schedule for cocaine abstinence prize contingency management on a traditional twice weekly schedule for cocaine abstinence standard care
Standard Care Plus Variable Interval Contingency Management
n=108 participants at risk
prize contingency management on a variable interval schedule for cocaine abstinence prize contingency management on a variable interval schedule for cocaine abstinence standard care
Psychiatric disorders
Suicidal Ideation
14.8%
9/61 • Number of events 11 • 18 months
3.8%
4/105 • Number of events 5 • 18 months
5.6%
6/108 • Number of events 6 • 18 months
General disorders
ER visit for overdose
4.9%
3/61 • Number of events 3 • 18 months
2.9%
3/105 • Number of events 5 • 18 months
2.8%
3/108 • Number of events 3 • 18 months

Additional Information

Sheila Alessi, PhD

UConn Health

Phone: 860-679-1849

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place