Kathryn McCollister1, Xuan Yang2, James R McKay3. 1. Department Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States. Electronic address: kmccolli@miami.edu. 2. Department Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States. 3. University of Pennsylvania and the Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, United States.
Abstract
INTRODUCTION: The study conducts a cost-effectiveness analysis (CEA) of a continuing care Telephone Monitoring and Counseling (TMC) intervention for adults diagnosed with cocaine dependence. Participants were randomly assigned to a control condition of intensive outpatient treatment only (treatment-as-usual, or TAU; N=108), or to one of two treatment conditions featuring TMC (N=106) and TMC plus incentives (TMC-plus; N=107). Follow-up assessments were conducted over a 2-year period. METHODS: Intervention and client costs were collected with the program and client versions of the Drug Abuse Treatment Cost Analysis Program (DATCAP). Effectiveness was measured as the number of days abstinent during follow-up. Secondary analyses consider alternative measures of effectiveness and the reduced societal costs of physical and mental health problems and criminal justice involvement. RESULTS: From the societal perspective, TMC dominates both TAU and TMC-plus as a cost-effective and cost-saving intervention. Results varied by substance-using status, however, with the subgroup of participants in TMC-plus that were using drugs at intake and early in treatment having the greatest number of days of abstinence and generating similar savings during follow-up than the TMC subgroup using drugs at intake. CONCLUSIONS:Telephone monitoring and counseling appears to be a cost-effective and potentially cost-saving strategy for reducing substance use among chronic substance users. Providing client incentives added to total intervention costs but did not improve overall effectiveness. CLINICAL TRIAL REGISTRATION: Clinical Trials.gov Number: NCT00685659.
RCT Entities:
INTRODUCTION: The study conducts a cost-effectiveness analysis (CEA) of a continuing care Telephone Monitoring and Counseling (TMC) intervention for adults diagnosed with cocaine dependence. Participants were randomly assigned to a control condition of intensive outpatient treatment only (treatment-as-usual, or TAU; N=108), or to one of two treatment conditions featuring TMC (N=106) and TMC plus incentives (TMC-plus; N=107). Follow-up assessments were conducted over a 2-year period. METHODS: Intervention and client costs were collected with the program and client versions of the Drug Abuse Treatment Cost Analysis Program (DATCAP). Effectiveness was measured as the number of days abstinent during follow-up. Secondary analyses consider alternative measures of effectiveness and the reduced societal costs of physical and mental health problems and criminal justice involvement. RESULTS: From the societal perspective, TMC dominates both TAU and TMC-plus as a cost-effective and cost-saving intervention. Results varied by substance-using status, however, with the subgroup of participants in TMC-plus that were using drugs at intake and early in treatment having the greatest number of days of abstinence and generating similar savings during follow-up than the TMC subgroup using drugs at intake. CONCLUSIONS: Telephone monitoring and counseling appears to be a cost-effective and potentially cost-saving strategy for reducing substance use among chronic substance users. Providing client incentives added to total intervention costs but did not improve overall effectiveness. CLINICAL TRIAL REGISTRATION: Clinical Trials.gov Number: NCT00685659.
Authors: Inbal Nahum-Shani; Ashkan Ertefaie; Xi Lucy Lu; Kevin G Lynch; James R McKay; David W Oslin; Daniel Almirall Journal: Addiction Date: 2017-02-18 Impact factor: 6.526
Authors: James R McKay; David H Gustafson; Megan Ivey; Fiona McTavish; Klaren Pe-Romashko; Brenda Curtis; David A Oslin; Daniel Polsky; Andrew Quanbeck; Kevin G Lynch Journal: Trials Date: 2018-01-30 Impact factor: 2.279