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A Complier Average Causal Effect Analysis of the Stimulant Reduction Intervention using Dosed Exercise Study.
Thomas Carmody1, Tracy L Greer1, Robrina Walker1
1University of Texas, Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390, USA.
Contemporary Clinical Trials Communications
|April 24, 2018
Summary
Adequately dosed exercise significantly reduced stimulant relapse probability and days of use among individuals in residential treatment. Improving exercise adherence is key to maximizing treatment effectiveness for substance use disorders.
Area of Science:
- Exercise science
- Addiction medicine
- Clinical trials
Background:
- Exercise shows promise for treating substance use disorders.
- Initial intention-to-treat analysis did not show exercise effectiveness compared to health education.
- Sub-optimal exercise adherence was identified as a potential barrier.
Purpose of the Study:
- To determine the potential effectiveness of adequately dosed exercise using a complier average causal effects (CACE) analysis.
- To investigate exercise's impact on stimulant use among individuals in residential treatment.
Main Methods:
- A randomized controlled trial (STimulant use Reduction Intervention using Dosed Exercise) compared a 12 kcal/kg/week exercise dose to health education.
- A post-hoc CACE analysis focused on participants with minimum adherence (≥8.3 KKW).
- The study included 218 participants with stimulant use disorder, assessing days of stimulant use via self-report and urine drug screens.
Main Results:
- The CACE analysis revealed a significantly lower probability of relapse to stimulant use in the exercise group (41.0%) versus the control group (55.7%, p<.01).
- Participants in the exercise group who relapsed had significantly fewer days of stimulant use (5.0 days) compared to the control group (9.9 days, p<.01).
Conclusions:
- Complier average causal effects (CACE) adjustment demonstrated significant positive effects of exercise on reducing stimulant use.
- Further research is needed to develop strategies for enhancing exercise adherence to achieve sufficient doses for significant treatment effects.
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