OBJECTIVE Contingency management (CM) is often criticized for limited long-term impact. This meta-analysis focused on objective indices of drug use (i.e., urine toxicology) to examine the effects of CM on illicit substance use up to 1 year following treatment. METHOD Analyses included randomized trials (k = 23) of CM for stimulant, opioid, or polysubstance use disorders that reported outcomes up to 1 year after the incentive delivery had ended. Using random effects models, odds ratios (OR) were calculated for the likelihood of abstinence. Metaregressions and subgroup analyses explored how parameters of CM treatment, namely escalation, frequency, immediacy, and magnitude of reinforcers, moderated outcomes. RESULTS The overall likelihood of abstinence at the long-term follow-up among participants who received CM versus a comparison treatment (nearly half of which were community-based comprehensive therapies or protocol-based specific therapies) was OR = 1.22, 95% confidence interval [1.01, 1.44], with low to moderate heterogeneity (I² = 36.68). Among 18 moderators, longer length of active treatment was found to significantly improve long-term abstinence. CONCLUSIONS CM showed long-term benefit in reducing objective indices of drug use, above and beyond other active, evidence-based treatments (e.g., cognitive-behavioral therapy, 12-step facilitation) and community-based intensive outpatient treatment. These data suggest that policymakers and insurers should support and cover costs for CM, which is the focus of hundreds of studies demonstrating its short-term efficacy and, now, additional data supporting its long-term efficacy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

中文翻译：

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应急管理治疗的长期疗效基于治疗后长达 1 年戒除非法物质使用的客观指标：荟萃分析。

目标 应急管理 (CM) 经常因长期影响有限而受到批评。该荟萃分析侧重于药物使用的客观指标（即尿液毒理学），以检查 CM 对治疗后长达 1 年的非法物质使用的影响。方法 分析包括针对兴奋剂、阿片类药物或多物质使用障碍的 CM 随机试验 (k = 23)，这些试验报告了在激励交付结束后长达 1 年的结果。使用随机效应模型，计算了禁欲可能性的优势比 (OR)。元回归和亚组分析探讨了 CM 治疗的参数，即升级、频率、即时性和强化物的强度，如何调节结果。结果 接受 CM 与比较治疗（其中近一半是基于社区的综合疗法或基于方案的特定疗法）的参与者在长期随访中戒断的总体可能性为 OR = 1.22，95% 置信区间[1.01, 1.44]，具有低到中等的异质性 (I² = 36.68)。在 18 位调节者中，发现较长时间的积极治疗可显着改善长期戒断。结论 CM 在降低药物使用的客观指标方面显示出长期益处，超过其他积极的、循证治疗（例如，认知行为疗法、12 步促进）和基于社区的强化门诊治疗。这些数据表明，政策制定者和保险公司应该支持和支付 CM 的成本，这是数百项证明其短期功效的研究的重点，现在，支持其长期功效的额外数据。（PsycInfo 数据库记录 (c) 2021 APA，保留所有权利）。