Contingency management for individuals with chronic health conditions: A systematic review and meta-analysis of randomized controlled trials.
Chronic health conditions
Contingency management
Medication adherence
Physical activity
Weight loss
Journal
Behaviour research and therapy
ISSN: 1873-622X
Titre abrégé: Behav Res Ther
Pays: England
ID NLM: 0372477
Informations de publication
Date de publication:
01 2021
01 2021
Historique:
received:
24
07
2020
revised:
24
10
2020
accepted:
16
11
2020
pubmed:
11
12
2020
medline:
26
10
2021
entrez:
10
12
2020
Statut:
ppublish
Résumé
Contingency management (CM) interventions involve providing reinforcement for engaging in a desired behavior, and have been shown to increase treatment adherence and promote abstinence in the treatment of substance use disorders. This review was conducted to systematically review the literature on the effectiveness of CM when applied to a range of medical conditions outside of substance use disorders. The authors identified a total of 24 randomized studies examining the effects of CM on four outcomes: weight change, physical activity, medication/device adherence, and viral load that were included in the qualitative summary, and 20 studies included in the meta-analysis. CM was associated with positive outcomes for physical activity and medication/device adherence compared to control conditions. Findings with weight loss and viral load were more mixed, and evidence for publication bias was found for both outcomes. The effects of CM tend to dissipate when the contingency is removed. Heterogeneity was observed across most outcomes. This review provides preliminary support for the use of CM in increasing physical activity and improving adherence to medication for chronic health conditions while reinforcement is ongoing. Future studies should examine potential moderators and identify strategies to maintain these changes over time.
Sections du résumé
BACKGROUND
Contingency management (CM) interventions involve providing reinforcement for engaging in a desired behavior, and have been shown to increase treatment adherence and promote abstinence in the treatment of substance use disorders. This review was conducted to systematically review the literature on the effectiveness of CM when applied to a range of medical conditions outside of substance use disorders.
METHOD
The authors identified a total of 24 randomized studies examining the effects of CM on four outcomes: weight change, physical activity, medication/device adherence, and viral load that were included in the qualitative summary, and 20 studies included in the meta-analysis.
RESULTS
CM was associated with positive outcomes for physical activity and medication/device adherence compared to control conditions. Findings with weight loss and viral load were more mixed, and evidence for publication bias was found for both outcomes. The effects of CM tend to dissipate when the contingency is removed. Heterogeneity was observed across most outcomes.
LIMITATIONS AND CONCLUSIONS
This review provides preliminary support for the use of CM in increasing physical activity and improving adherence to medication for chronic health conditions while reinforcement is ongoing. Future studies should examine potential moderators and identify strategies to maintain these changes over time.
Identifiants
pubmed: 33302054
pii: S0005-7967(20)30235-7
doi: 10.1016/j.brat.2020.103781
pii:
doi:
Types de publication
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
103781Informations de copyright
Copyright © 2020 Elsevier Ltd. All rights reserved.