1. A complier average causal effect analysis of the Stimulant Reduction Intervention using dosed exercise study
- Author
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Chad D. Rethorst, Thomas J. Carmody, Tracy L. Greer, Madhukar H. Trivedi, and Robrina Walker
- Subjects
Clinical trials network ,Stimulant abuse or dependence ,medicine.medical_specialty ,STRIDE, STimulant Reduction Intervention using Dosed Exercise ,medicine.medical_treatment ,UDS, Urine Drug Screens ,RTP, Residential Treatment Program ,01 natural sciences ,Article ,law.invention ,010104 statistics & probability ,03 medical and health sciences ,KKW, kilocalories/kilogram/week ,0302 clinical medicine ,Randomized controlled trial ,law ,Internal medicine ,Intervention (counseling) ,medicine ,Exercise intervention ,030212 general & internal medicine ,0101 mathematics ,Pharmacology ,Stimulant abuse ,ITT, Intention-to-Treat ,lcsh:R5-920 ,business.industry ,Causal effect ,General Medicine ,medicine.disease ,Clinical trial ,Substance abuse ,Stimulant ,Complier average causal effects ,TLFB, Timeline Follow Back ,Health education ,lcsh:Medicine (General) ,business ,SUD, Substance Use Disorders ,CACE, Complier Average Causal Effect - Abstract
Objective: Exercise is a promising treatment for substance use disorders, yet an intention-to-treat analysis of a large, multi-site study found no reduction in stimulant use for exercise versus health education. Exercise adherence was sub-optimal; therefore, secondary post-hoc complier average causal effects (CACE) analysis was conducted to determine the potential effectiveness of adequately dosed exercise. Method: The STimulant use Reduction Intervention using Dosed Exercise study was a randomized controlled trial comparing a 12 kcal/kg/week (KKW) exercise dose versus a health education control conducted at nine residential substance use treatment settings across the U.S. that are affiliated with the National Drug Abuse Treatment Clinical Trials Network. Participants were sedentary but medically approved for exercise, used stimulants within 30 days prior to study entry, and received a DSM-IV stimulant abuse or dependence diagnosis within the past year. A CACE analysis adjusted to include only participants with a minimum threshold of adherence (at least 8.3 KKW) and using a negative-binomial hurdle model focused on 218 participants who were 36.2% female, mean age 39.4 years (SD = 11.1), and averaged 13.0 (SD = 9.2) stimulant use days in the 30 days before residential treatment. The outcome was days of stimulant use as assessed by the self-reported TimeLine Follow Back and urine drug screen results. Results: The CACE-adjusted analysis found a significantly lower probability of relapse to stimulant use in the exercise group versus the health education group (41.0% vs. 55.7%, p
- Published
- 2018