Clinical trial NCT05515757: Hospital-Based Contingency Management
Official title: Development of a Hospital-Based Contingency Management Intervention
Study type: INTERVENTIONAL
Overall status: ENROLLING_BY_INVITATION
Phase: NA
Conditions: Amphetamine-Related Disorders
Keywords: Amphetamine-Related Disorders
substance-related disorders
behavior therapy
psychology reinforcement
hospital medicine
Lead sponsor: Oregon Health and Science University
Sponsor class: OTHER
Collaborators: name: CareOregon
name: Affect Therapeutics, Inc.
First posted: 2022-08-25
Enrollment: 90
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: This study aims to adapt an outpatient mobile app-based contingency management intervention to the hospital setting to understand how we can use contingency management to improve health outcomes in hospitalized patients with stimulant use disorders.

Detailed description: Contingency management (CM), an evidence-based strategy that utilizes a reward-based system as positive reinforcement, has been most robustly studied in the outpatient setting, but also has the potential to improve hospital care for patients with stimulant use disorder. The hospital is a challenging environment for people who use drugs. Conflicts with staff often result from in-hospital substance use, prolonged time off the unit, and missing medications, leading to negative health outcomes and re-admissions. By relying on positive rewards to encourage positive health behaviors, CM has the potential to improve staff-patient relationships, healthcare engagement, and reduce substance use in the hospital. Stimulant use disorder is especially difficult to address in the hospital due to a lack of medications that can support cravings and withdrawal symptoms. However, little is known about CM implementation in hospitals and the hospital setting may introduce unique challenges.

The objective of this study is to adapt an outpatient mobile app-based CM intervention to the hospital setting to understand the feasibility and acceptability of a hospital-based CM intervention to improve health outcomes in hospitalized patients with substance use disorders. We'll achieve this objective through following specific aims: Aim 1: Identify adaptations needed to implement an evidence-based outpatient mobile-app based CM intervention to the hospital setting for hospitalized patients with substance use disorders. Aim 2: Determine the feasibility, including facilitators and barriers, of implementing a mobile app-based CM intervention in the hospital setting. Aim 3: Assess the acceptability of a mobile app-based hospital-based CM intervention to patients and staff.

Eligibility criteria: Inclusion Criteria:

* Be 18 years of age or older
* Have moderate to severe stimulant use disorder, as diagnosed using DSM-5 criteria for stimulant use disorder by an addiction medicine provider
* Have an anticipated hospital length of stay greater than 2 weeks
* Be able to use a smartphone and agree to download and use the Affect app as part of study-related procedures
* Be English speaking and be able to understand explanations of study procedures and the informed consent to participate

Exclusion Criteria:

* Unable to engage in the intervention due to cognitive impairment or altered mental status
* Unable to engage in the intervention due to acute medical/mental health issues, per judgement of the research assistant

Primary outcomes:
measure: Intervention acceptability and feasibility
timeFrame: Week 0-8
Secondary outcomes:
measure: Brief Addiction Monitor (BAM)
timeFrame: Week 0-8
measure: Participant engagement in the contingency management intervention
timeFrame: Week 0-8
measure: Participant drug test results
timeFrame: Week 0-8
Other outcomes:
Locations:
city: Portland
country: United States
facility: Linda Peng
state: Oregon
Study officials:
References: