A Systematic Review of the Efficacy of Contingency Management for Substance Use Disorders in Low and Middle Income Countries.
Contingency management
Low and middle income countries
Substance use disorders
Substance use treatment
Journal
International journal of behavioral medicine
ISSN: 1532-7558
Titre abrégé: Int J Behav Med
Pays: England
ID NLM: 9421097
Informations de publication
Date de publication:
02 Aug 2023
02 Aug 2023
Historique:
accepted:
23
06
2023
medline:
3
8
2023
pubmed:
3
8
2023
entrez:
2
8
2023
Statut:
aheadofprint
Résumé
The impact of illicit substance use is especially devastating in low-resourced countries where factors such as poverty, unemployment, and inadequate services impede successful treatment. Contingency management (CM) is a treatment for substance use disorders that has shown to be effective in eliciting behaviour change. The efficacy of CM interventions in low and middle income countries (LMICs) has been under explored. The aim of this systematic review of randomized controlled trials was to assess measures of CM efficacy in addressing substance use disorders, while also considering contextual moderators of CM in LMICs. A search of PubMed, Scopus, and Cochrane library databases yielded 18 studies for inclusion, from which relevant data were extracted using modified versions of the Cochrane Characteristics of Studies tool. Two studies were located in a low-income country, two in lower-middle income countries, and fourteen in upper middle-income countries. Overall, estimated efficacy estimates were similar to those from higher income countries. However, context-specific challenges that warrant further investigation included limited access to trained staff and structural and financial constraints. While CM in LMICs is in its early stages of development, efficacy estimates were not substantially different compared to high income countries. Challenges such as costs, willingness to implement, and the stigma associated with addiction sets the stage for further research in these contexts.
Sections du résumé
BACKGROUND
BACKGROUND
The impact of illicit substance use is especially devastating in low-resourced countries where factors such as poverty, unemployment, and inadequate services impede successful treatment. Contingency management (CM) is a treatment for substance use disorders that has shown to be effective in eliciting behaviour change. The efficacy of CM interventions in low and middle income countries (LMICs) has been under explored.
METHODS
METHODS
The aim of this systematic review of randomized controlled trials was to assess measures of CM efficacy in addressing substance use disorders, while also considering contextual moderators of CM in LMICs. A search of PubMed, Scopus, and Cochrane library databases yielded 18 studies for inclusion, from which relevant data were extracted using modified versions of the Cochrane Characteristics of Studies tool.
RESULTS
RESULTS
Two studies were located in a low-income country, two in lower-middle income countries, and fourteen in upper middle-income countries. Overall, estimated efficacy estimates were similar to those from higher income countries. However, context-specific challenges that warrant further investigation included limited access to trained staff and structural and financial constraints.
CONCLUSIONS
CONCLUSIONS
While CM in LMICs is in its early stages of development, efficacy estimates were not substantially different compared to high income countries. Challenges such as costs, willingness to implement, and the stigma associated with addiction sets the stage for further research in these contexts.
Identifiants
pubmed: 37532862
doi: 10.1007/s12529-023-10197-8
pii: 10.1007/s12529-023-10197-8
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : NIDA NIH HHS
ID : R21DA040492
Pays : United States
Informations de copyright
© 2023. International Society of Behavioral Medicine.
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