Table 4.

Hierarchy of Treatment Outcomes for Studies Designed to Evaluate Computer-Based Interventions for Drug Use

Studies Evaluating Drug Use Outcomes
Author (year)	Study quality	Analysis types	Control group	Attrition rate	Primary outcome measures	Results
Bickel et al. (2008)	21	Intent to treat	TAUb and therapist-delivered CRAc	Computer CRAc - 62%	Urine toxicology (3×/week) Helping alliance questionnaire Patient-therapist contact time	Both CRAc groups were abstinent for significantly longer than TAUb No differences No differences Substantially contact time for computer CRAc
				Therapist CRAc – 58%
				Standard – 53%
Carroll et al. (2008, 2009)	20	Intent to treat, treatment exposed	TAUb	Experimental -33%	Retention Urine toxicology (number positive, percent positive, longest continuous abstinence) Follow-up urine toxicology (1, 3 and 6 month) Self-reported drug use (Total days abstinent, consecutive days abstinent) Satisfaction	No differences Fewer positive utoxes lower percent of positive utoxes Longer duration of continuous abstinence significantly lower proportion of positive utoxes at 1 month no differences at 3 and 6 month No difference longer consecutive days abstinent High mean ratings
				Control – 312%
				82% During post treatment follow up
Chopra et al. (2009)a	19	Intent to treat	TAUb	Voucher contingency-85%	Retention Urine toxicology (longest continuous abstinence, total weeks abstinence)	Greater retention rate for VCe compared to MCd, but not TAUb MCd and VCe more continuous weeks abstinent from opioids VCe more weeks abstinent from opioids
				Medication contingency- 60%
				TAUb – 76%
Kay-Lambkin et al. (2009)	20	Intent to treat	Therapist delivered CBTf, Single brief intervention	Computer – 72%	Depression Self reported alcohol use	No difference No difference
				Therapist – 66%
				Single BIg – 70%	Self reported cannabis use	Greater reduction for computer and therapist than single BIg
Ondersma et al. (2005)	18	Intent to treat	Assessment only	Experimental – 33%	Self reported drug use Motivation to change Satisfaction	No difference No difference High mean ratings
				Control – 20%
Ondersma et al. (2007)	24	Intent to treat, completers only	Assessment only	Experimental – 29%	Urine toxicology (3 month) Self reported drug use frequency	No difference Greater reduction for all substances
				Control – 29%
Barber (1990)	6	Intent to treat	TAUb	NPi	Self efficacy	Greater improvement
Grohman & Fals-Stewart (2003)	18	Intent to treat	TAUb and computer-assisted typing tutorial	Experimental – 62%	Retention Graduation rate	Longer retention Higher graduation rate
				TAUb – 82%
				Typing group – 82%
Grohman et al. (2006)	13	Intent to treat	TAUb	NPi	Retention Neuropsychological tests (weeks 2 and 4) Therapist ratings of patient behavior (week 2)	Longer retention No difference Better overall attitude
Hall & Huber (2000)	11	Intent to treat	TAUb, offsite case manager	NPi	Cost Satisfaction	50% less labor cost Greater satisfaction than offsite case management Less satisfaction than TAUb
Marsch & Bickel (2004)	18	Completers only	Counselor-facilitated instruction	0	Drug and sex related risk behaviors HIV/AIDS related knowledge Requested HIV test location Satisfaction	No difference Greater knowledge accuracy More requested test location Greater interest
Ruggiero et al. (2006)	15	Completers only	None	50%	Module completion Satisfaction	Of eligible only 25% completed cannabis module Majority satisfied

^aComputer-delivered CRA^c was confounded with contingency management (medication or voucher). Both conditions were compared to Standard care.

^bTreatment as usual

^cCommunity reinforcement approach

^dMedication contingency

^eVoucher contingency

^fCognitive behavioral therapy

^gBrief intervention

ⁱNot provided