IMPLEMENTING CONTINGENCY MANAGEMENT WITHIN MEDICATION-ASSISTED TREATMENT

Healthcare providers engaged in medication-assisted treatment (MAT) for opioid use disorder frequently observe low rates of abstinence and poor patient retention within the first month of treatment. Can contingency management, an evidenced-based behavioral therapy, be implemented in an effective manner to improve upon these outcomes by promoting positive patient behavior and incentivizing the achievement of therapeutic goals? Using the Model for Improvement, a DNP project developed a contingency management protocol at an outpatient opioid treatment program delivering MAT. Over an implementation window of nine weeks, 3 plan-do-study-act cycles were completed. The protocol was continuously revised, facilitating staff compliance and improving the effectiveness of the intervention. New patients were rewarded with positive reinforcement for achieving their first negative drug screen, and positive patient outcomes were observed to be associated with the intervention. With the final iteration of the protocol, the project demonstrated that contingency management may be implemented within MAT in a feasible, sustainable manner that encourages an optimal rate of staff compliance. The results of the project suggest that patients who receive contingency management after achieving abstinence are more likely to maintain their abstinence and remain in treatment when compared to a patient cohort who had not received the intervention 28 days before implementation of the project.Doctor of Nursing Practic