TES Research

The National Institute on Drug Abuse

The National Drug Abuse Research Clinical Trials Network (CTN) sponsored a study referenced as CTN-0044.

The Primary Objective of CTN-0044 was to conduct a multi-site trial of the effectiveness Trial of TES as an interactive, web-based version of the Community Reinforcement Approach (CRA) plus incentives targeting drug abstinence and treatment participation as part of community-based, outpatient substance abuse treatment

Design

• NIDA’s Clinical Trials Network Platform
• Multi-site, controlled trial
• 10 sites, approximately 50 participants at each site (N=507)
• Participants seeking outpatient treatment for substance abuse disorder (excluding opioid pharmacotherapy)
• Any substance problem
• Minimal exclusionary criteria
• Random Assignment

1. TAU
2. Modified TAU + TES/CM
   Modified TAU reduced clinician-administered counseling time by ~ 2 hours
   Clinicians “checked-in” briefly with participants about TES during individual counseling sessions.

Outcomes

Abstinence

• TES doubled the odds of abstinence in clients who were using in the 30 days prior to baseline
• TES was as good as TAU in clients who were abstinent at baseline
• TES clients had more consecutive time abstinent

Retention

• TES reduced treatment dropout
• 48% of TES clients stayed in treatment for 12 weeks compared to 40% of TAU clients

Conclusions

1. TES effect was greater among patients who tested positive for substances at baseline

2. Findings suggest that TES can be substituted for a portion of face-to-face counseling and produce better outcomes (i.e., abstinence and retention)

Campbell et al (2014)

CTN-0044 Ancillary Studies

American Indian population

• Explored the acceptability of TES among a sample of 40 urban American Indians/Alaska Natives enrolled in 2 outpatient SUD programs
• 8 weeks of TES plus TAU
• Overall good acceptability, with highest ratings for modules addressing STDs and drug use triggers
• Client feedback suggested modifications, such as using more native language or slang, references to spirituality and the natural world, & native actors

Organizational Factors

• Assessed the influence of practitioner attitudes & norms on intention to use web-based interventions
• Data collected from clinicians & program directors (n=143) during visits prior to TES implementation
• Main outcomes include:
  • Social norms are the primary influence on intention to use web-based interventions
  • Need social normative interventions to support adoption of new technologies in drug abuse treatment programs
  • Workforce & organizational variables had little influence on counselor intentions

Findings from other Studies of TES

In outpatients with opioid dependence, computer-administered CRA with vouchers produced similar abstinence weeks & longer continuous abstinence than therapist-administered CRA with vouchers and reduced therapist time. (Bickel et al., 2008)

TES was an effective adjunct to HIV prevention education for youth in substance abuse treatment.

TES plus counseling produced greater 12-month abstinence than counseling alone. (Marsch et al., 2011)

In a prison population, TES was as effective as standard treatment in

• reducing drug use, HIV risk, & self-reported criminal behavior at 3- & 6-months post-release, and
• greater reported treatment satisfaction & completion. (Chaple et al., 2013)

TES References