Voucher incentives increase treatment participation in telephone-based continuing care for cocaine dependence

University of Pennsylvania, Department of Psychiatry, Center on the Continuum of Care in the Addictions, Philadelphia, PA 19104, USA.
Drug and alcohol dependence (Impact Factor: 3.42). 10/2010; 114(2-3):225-8. DOI: 10.1016/j.drugalcdep.2010.09.007
Source: PubMed


Telephone-based monitoring is a promising approach to continuing care of substance use disorders, but patients often do not engage or participate enough to benefit. Voucher incentives can increase retention in outpatient treatment and continuing care, but may be less effective when reinforcement is delayed, as in telephone-based care. We compared treatment utilization rates among cocaine-dependent patients enrolled in telephone continuing care with and without voucher incentives to determine whether incentives increase participation in telephone-based care.
Participants were 195 cocaine-dependent patients who completed two weeks of community-based intensive outpatient treatment for substance use disorders and were randomly assigned to receive telephone continuing care with or without voucher incentives for participation as part of a larger clinical trial. The 12-month intervention included 2 in-person orientation sessions followed by up to 30 telephone sessions. Incentivized patients could receive up to $400 worth of gift cards.
Patients who received incentives were not more likely to complete their initial orientation to continuing care. Incentivized patients who completed orientation completed 67% of possible continuing care sessions, as compared to 39% among non-incentivized patients who completed orientation. Among all patients randomized to receive incentives, the average number of completed sessions was 15.5, versus 7.2 for patients who did not receive incentives, and average voucher earnings were $200.
Voucher incentives can have a large effect on telephone continuing care participation, even when reinforcement is delayed. Further research will determine whether increased participation leads to better outcome among patients who received incentives.

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    • "Incentivizing attendance has increased attendance rates in treatment for substance use disorders, although the magnitude of effects has been somewhat smaller than when abstinence is incentivized (Bride & Humble, 2008; Businelle et al., 2009; Lussier et al., 2006; Petry et al., 2006). A preliminary analysis of continuing care participation in the present study indicated that incentives dramatically increased the number of sessions attended in the first year of the follow-up (Van Horn, et al., 2011). "
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