TY - JOUR
KW - Adult
KW - Behavior Therapy/trends
KW - Central Nervous System Stimulants/adverse effects
KW - Female
KW - Humans
KW - Male
KW - Patient Compliance/psychology
KW - Substance-Related Disorders/epidemiology/psychology/therapy
KW - United States/epidemiology
KW - United States Department of Veterans Affairs/trends
KW - Veterans/psychology
KW - Contingency management
KW - Department of Veterans Affairs
KW - Stimulants
AU - D. DePhilippis
AU - N. M. Petry
AU - M. O. Bonn-Miller
AU - S. B. Rosenbach
AU - J. R. McKay
A1 - 
AB - BACKGROUND: In 2011, the Department of Veterans Affairs launched an initiative to expand patients' access to contingency management (CM) for the treatment of substance use disorders, particularly stimulant use disorder. This study evaluates the uptake and effectiveness of the VA initiative by presenting data on participation in coaching, fidelity to key components of the CM protocol, and clinical outcomes (CM attendance and substance use). METHODS: Fifty-five months after the first VA stations began offering CM to patients in June 2011, 94 stations had made CM available to 2060 patients. As those 94 VA stations began delivering CM to Veterans, their staff participated in coaching calls to maintain fidelity to CM procedures. As a part of the CM coaching process, those 94 implementation sites provided data describing the setting and structure of their CM programs as well as their fidelity practices. Additional data on patients' CM attendance and urine test results also were collected from the 94 implementation sites. RESULTS: The mean number of coaching calls the 94 programs participated in was 6.5. The majority of sites implemented CM according to recommended standard guidelines and reported high fidelity with most CM practices. On average, patients attended more than half their scheduled CM sessions, and the average percent of samples that tested negative for the target substance was 91.1%. CONCLUSION: The VA's CM implementation initiative has resulted in widespread uptake of CM and produced attendance and substance use outcomes comparable to those found in controlled clinical trials.
AD - Center of Excellence in Substance Addiction Treatment and Education, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, 19104, United States; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, United States. Electronic address: dominick.dephilippis@va.gov.; Calhoun Cardiology Center, University of Connecticut Health Center, Farmington, CT, 06030, United States.; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, United States.; Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, 10003, United States.; Center of Excellence in Substance Addiction Treatment and Education, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, 19104, United States; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, United States.
BT - Drug and alcohol dependence
C5 - Education & Workforce; Healthcare Disparities; Opioids & Substance Use
DO - 10.1016/j.drugalcdep.2017.12.020
JF - Drug and alcohol dependence
LA - eng
M1 - Journal Article
N2 - BACKGROUND: In 2011, the Department of Veterans Affairs launched an initiative to expand patients' access to contingency management (CM) for the treatment of substance use disorders, particularly stimulant use disorder. This study evaluates the uptake and effectiveness of the VA initiative by presenting data on participation in coaching, fidelity to key components of the CM protocol, and clinical outcomes (CM attendance and substance use). METHODS: Fifty-five months after the first VA stations began offering CM to patients in June 2011, 94 stations had made CM available to 2060 patients. As those 94 VA stations began delivering CM to Veterans, their staff participated in coaching calls to maintain fidelity to CM procedures. As a part of the CM coaching process, those 94 implementation sites provided data describing the setting and structure of their CM programs as well as their fidelity practices. Additional data on patients' CM attendance and urine test results also were collected from the 94 implementation sites. RESULTS: The mean number of coaching calls the 94 programs participated in was 6.5. The majority of sites implemented CM according to recommended standard guidelines and reported high fidelity with most CM practices. On average, patients attended more than half their scheduled CM sessions, and the average percent of samples that tested negative for the target substance was 91.1%. CONCLUSION: The VA's CM implementation initiative has resulted in widespread uptake of CM and produced attendance and substance use outcomes comparable to those found in controlled clinical trials.
PY - 2018
SN - 1879-0046; 0376-8716; 0376-8716
SP - 367
EP - 373
EP - 
T1 - The national implementation of Contingency Management (CM) in the Department of Veterans Affairs: Attendance at CM sessions and substance use outcomes
T2 - Drug and alcohol dependence
TI - The national implementation of Contingency Management (CM) in the Department of Veterans Affairs: Attendance at CM sessions and substance use outcomes
U1 - Education & Workforce; Healthcare Disparities; Opioids & Substance Use
U2 - 29524874
U3 - 10.1016/j.drugalcdep.2017.12.020
VL - 185
VO - 1879-0046; 0376-8716; 0376-8716
Y1 - 2018
Y2 - Apr 1
ER -