App-Based Contingency Management for Substance Use Disorders

Recruiting at 1 trial location

Overseen By Mercedes Robaina

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Wake Forest University Health Sciences

Disqualifiers: Active psychosis, Cognitive impairment, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 3 months

175 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether an app called DynamiCare can assist people with substance use disorders, such as issues with opioids, cocaine, or meth, by offering rewards to encourage positive behaviors. It examines how different reward amounts and structures work, particularly for older adults. Participants will be divided into groups to test various incentive methods, with some receiving constant amounts and others receiving changing amounts based on behavior. Suitable candidates have recently used drugs like opioids, cocaine, or meth, own a smartphone, and are in some form of treatment program. As an unphased trial, this study provides a unique opportunity to contribute to innovative research that could enhance treatment strategies for substance use disorders.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What prior data suggests that app-based incentives are safe for older adults with substance use disorders?

Research shows that the DynamiCare app, which uses rewards to encourage healthy habits, is well-received by people with substance use disorders (SUDs). Studies confirm that this method is safe and effective, with over 100 trials supporting its benefits and no serious side effects reported.

One study tested its practicality, where participants used the DynamiCare app to manage substance use, and results indicated it was both accepted and effective. No major negative effects or safety issues were reported. The app includes self-testing and rewards, which have been proven to safely support recovery. Overall, current evidence supports the safety of using the DynamiCare app for managing substance use disorders. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the DynamiCare app because it offers a fresh approach to treating substance use disorders. Unlike traditional treatments that often rely on counseling or medication, this app uses a method called contingency management, rewarding users with incentives for drug-free tests. This approach not only motivates positive behavior but is also delivered through a convenient and accessible app, making it more engaging and potentially more effective for users. Moreover, the trial explores different incentive strategies, such as escalating rewards or constant rewards, to determine the most effective way to encourage sustained recovery. This innovative, tech-driven approach could revolutionize how substance use disorders are managed.

What evidence suggests that this trial's app-based incentives could be effective for substance use disorders?

Research shows that an app-based approach called contingency management (CM) offers a promising way to treat substance use disorders (SUDs). Studies have found CM to be one of the most effective methods for reducing substance use, with over 100 well-designed studies supporting its success. In this trial, participants will use the DynamiCare app, which employs this method. The trial includes various treatment arms, such as "Escalating High" and "De-Escalating Low," where participants receive different incentive structures for drug-negative tests. Data suggest that the DynamiCare app helps people stay substance-free by offering rewards, and evidence supports its effectiveness in helping individuals with SUDs achieve better treatment results. ^{1 3 4 5 6}

Who Is on the Research Team?

Mercedes Robaina

Principal Investigator

Wake Forest University Health Sciences

Are You a Good Fit for This Trial?

Adults with opioid, cocaine, or methamphetamine use disorders who are in substance treatment programs can join. They must have a smartphone and be willing to use the DynamiCare app. Ideal candidates recently started treatment or used substances within the last 21 days. Those with active psychosis or significant cognitive impairment that affects participation cannot join.

Inclusion Criteria

I am currently in a substance abuse treatment program.

Have an email and can access it from their smartphone

Understands English

Exclusion Criteria

Have evidence of active (non-substance related) psychosis that might impair participation as determined by the PI

I do not have severe cognitive issues that require a legal guardian.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants use the DynamiCare app to receive incentives for drug-negative saliva tests, with varying incentive structures across groups

3 months

Remote monitoring via app

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• DynamiCare app (app-based contingency management)
• Sham control

Trial Overview The trial is testing if an app called DynamiCare, which offers incentives for staying drug-free, works well for older adults compared to younger ones. Participants will either get real incentives through the app or be in a control group without real rewards.

How Is the Trial Designed?

Group I: Escalating Low Experimental Treatment 1 Intervention

Participants will have access to the DynamiCare app. Through the app, participants will receive incentive amounts for drug negative saliva tests. Incentive amounts increase with every negative drug test up to a ceiling and "reset" to the lowest amount when a test is positive or missed. The "Low" group will receive lower incentive amounts than the "High" group.

Group II: Escalating High Experimental Treatment 1 Intervention

Participants will have access to the DynamiCare app. Through the app, participants will receive incentive amounts for drug negative saliva tests. Incentive amounts increase with every negative drug test up to a ceiling and "reset" to the lowest amount when a test is positive or missed. The "High" group will receive higher incentive amounts than the "Low" group.

Group III: De-Escalating Low Experimental Treatment 1 Intervention

Participants will have access to the DynamiCare app. Through the app, participants will receive incentive amounts for drug negative saliva tests. Incentive amounts increase with every positive drug tests (up to a ceiling), and decrease by the same increment with every negative drug test (down to a floor). The "Low" group will receive lower incentive amounts than the "High" group.

Group IV: De-Escalating High Experimental Treatment 1 Intervention

Participants will have access to the DynamiCare app. Through the app, participants will receive incentive amounts for drug negative saliva tests. Incentive amounts increase with every positive drug tests (up to a ceiling), and decrease by the same increment with every negative drug test (down to a floor). The "High" group will receive higher incentive amounts than the "Low" group.

Group V: Constant Low Experimental Treatment 1 Intervention

In the Constant groups, incentive amounts will remain unchanged across time. The "Low" group will receive lower incentive amounts than the "High" group.

Group VI: Constant High Experimental Treatment 1 Intervention

In the Constant groups, incentive amounts will remain unchanged across time. The "High" group will receive higher incentive amounts than the "Low" group.

Group VII: Control Placebo Group 1 Intervention

Participants in this group will have access to the DynamiCare app; however, no behavioral incentives will be provided to this group.

Who Is Running the Clinical Trial?

Wake Forest University Health Sciences

Lead Sponsor

Trials

1,432

Recruited

2,506,000+

Aurora Health Care

Lead Sponsor

Trials

46

Recruited

16,400+

University of Chicago

Collaborator

Trials

1,086

Recruited

844,000+

Massachusetts Institute of Technology

Collaborator

Trials

104

Recruited

12,810,000+

University of California Santa Cruz

Collaborator

Trials

7

Recruited

2,300+

University of California, Santa Cruz

Collaborator

Trials

5

Recruited

2,100+

Rogers Behavioral Health

Collaborator

Trials

3

Recruited

1,200+

Citations

1. dynamicarehealth.com dynamicarehealth.com/contingency-management

Contingency Management CM is one of the most effective and evidence-based psychosocial treatments for substance use disorders. In over 100 randomized controlled trials and 9 meta- ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8197772/

Digital delivery of a contingency management intervention ... These data suggest that DynamiCare Health is feasible and potentially beneficial as a complement to community substance use treatment programs.

3. dynamicarehealth.com dynamicarehealth.com/cm-reports

Contingency Management Reports — DynamiCare Health The following free reports have been developed by DynamiCare and are being provided to the public for education on the contingency management model.

4. clinicaltrials.gov clinicaltrials.gov/study/NCT04162132

Contingency Management Using Smartphone App in ... The purpose of this research study is to test the acceptance and efficacy of a smartphone app (DynamiCare Rewards) for patients with substance use disorder (SUD) ...

5. jamanetwork.com jamanetwork.com/journals/jamanetworkopen/fullarticle/2827185

Smartphone App–Based Contingency Management and ... These findings suggest that adding app-based contingency management to MOUD is associated with better treatment outcomes in clinical settings.

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12263680/

Digitally delivered contingency management during ... Digital delivery of a contingency management intervention for substance use disorder: A feasibility study with DynamiCare Health. J Subst Abuse ...