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Table 2 Details from included studies examining retention in MOUD

From: The impact of methamphetamine/amphetamine use on receipt and outcomes of medications for opioid use disorder: a systematic review

Author/year Study design Time period Setting Population Adjunctive servicesa Total N Meth/amph measure MOUD measure Analysis Covariatesb Associationc Direction (retention)
Banta-Green 2009 Long-itudinal 2004–2005 Washington state, US; methadone tx programs Adult patients initiating methadone 2308 Meth use “at time of intake” (self-report) Retention at 1 year after initiation Logistic regression Demographics, social factors, physical health, other substance use, tx agency aOR: 0.62 (95% CI 0.44–0.89),
p  =  0.009
Negative
n  =  164
Deck 2005 Long-itudinal 1994–1999 Oregon and Washington, US; publicly funded methadone tx programs Medicaid eligible adults initiating methadone OR: 3185 Amph use in past 30 days at initiation (self-report) Retention at 1 year after initiation Logistic regression Demographics, social factors, other substance use, mental health, prior tx, referral source, distance from clinic, tx agency Oregon: aOR  =  0.76 (95% CI 0.57–0.83) Negative (Oregon only)
WA: 5103 Ns not presented for first episode only; 8% (Ore.), 5% (Wash.) of all tx episodes Washington: aOR  =  1.01 (95% 0.70–1.45)
Hser 2014 Long-itudinal (RCT data) 2006–2009 US; federally-licensed OUD tx programs (various locations) Adult patients initiating bup or methadone in RCT Total: 1267 Amph use during 24-week f/u period (UDS) Time to discontinuation Cox PH model Demographics, physical/mental health, other substance use, site, dose, MOUD type (in total sample) Total sample: aHR = 4.87 (95% CI: 3.75–6.34)
Bup: aHR  =  4.50 (95% CI 3.32–6.10) Methadone: aHR  =  6.85 (95% CI 4.00–11.72),
Negative
Bup: 738 Ns at initiation
 Total sample n  =  114
Meth-adone: 529  Bup n  =  64 (all p  <  0.01)
 Methadone n  =  50
Liu 2017 Long-itudinal 2013–2014 Guangzhou, China; methadone tx programs Adult patients receiving methadone, with heroin use prior to tx 401 Meth use in past 6 months at baseline survey (self-report) Time to discontinuation Cox PH model Marital status, # of times in “compulsory drug detoxification” aHR  =  2.26 (95% CI 1.15–4.43),
p  =  0.017
Negative
n  =  31
Lo 2018 Long-itudinal 2005–2015 Vancouver, Canada; community survey Adult PWUD reporting methadone tx in past 6 months 1301 At least daily meth use in past 6 months (self-report; repeated measure) Reporting discontinuation in past 6 months (repeated measure) GEE model with logit link Demographics, social factors, other substance use, HIV, dose, % of visits on methadone Crude OR  =  1.75 (95% CI 1.07–2.85),
p  =  0.025
aOR  =  1.02 (95% CI 0.61–1.69),
p  =  0.951
Negative (unadjusted only)
n  =  66 at baseline
Morgan 2018 Long-itudinal 2010–2014 US; national insurance claims data Commercially insured individuals with OUD initiating bup or naltrex 38,190 Amph UD during study period (dx codes; abuse or dependence) Time to discontinuation Cox PH model Demographics, other substance use, ever had detox, provider type, clinic setting, type of insurance, MOUD type aHR 1.07 (95% CI 1.03–1.12),
p  =  0.002
Negative
n  =  2353
Peles 2008 Long-itudinal Tel Aviv: 1993–2004
Las Vegas: 2000–2005
Tel Aviv, Israel and Las Vegas, Nevada, US; methadone tx programs Adult patients initiating methadone Individual therapy (both clinics): group therapy (required Tel Aviv; encouraged Las Vegas) Tel Aviv: 492 Amph use at initiation (UDS) Retention at 1 year after initiationd Tel Aviv: Fisher’s exact test Tel Aviv: none Tel Aviv: Fisher’s exact
p  =  0.2
Negative (Las Vegas clinic only)
Las Vegas: 302 Tel Aviv: n  =  45 Las Vegas: logistic regression Las Vegas: demographics, duration of opioid use, Hepatitis C Las Vegas: aOR for NO amph use  =  2.1 (95% CI 1.05–4.2)
Las Vegas: n  =  47
Skeie 2013 Long-itudinal 1998–2007 Hedmark county/Oppland county, Norway; public OUD tx program Adult patients receiving bup or methadone 131 Years of amph dependence during lifetime (structured interview) Interruption of tx (planned or unplanned) during study period Independent samples t test None Mean 9.2 years in interrupter group; 5.5 years in other group; t test
p  =  0.048
Negative
n not reported
Tsui 2020 Long-itudinal 2015–2018 Washington state, US; primary care bup tx program in urban hospital; rural telemedicine bup tx program Adult patients initiating bup 768 Meth use in past 30 days at initiation (self-report; any vs. none and # of days) Time to discontinuation Cox PH models (ref group: no meth use) Demographics, clinic site, time period of enrollment Any use aHR: 2.39 (95% CI 1.94–2.93)
1–10 days aHR: 2.05 (95% CI 1.63–2.57)
11–20 days aHR: 3.04 (95% CI 2.12–4.23)
21–30 days aHR: 3.61 (95% CI 2.40–5.23)
Negative
n  =  237 (any use)
Schiff 2007 Long-itudinal 2004–2005 Israel; methadone tx programs (various locations) Adult patients receiving methadone 2664 Amph use during tx (UDS) 100% retention during 13-month study period Logistic regression Demographics, other substance use aOR  =  1.48 (95% CI 1.08-2.02),
p  =  0.015
Positive
(n not reported)
Hui 2017 Long-itudinal 2002–2014 Boston, MA, US; primary care bup tx in large safety-net medical center Adult patients initiating bup Behavioral health counseling required 1127 Amph use in first month of tx (UDS) Discontinuation within 30 days after initiation X2 test None 4.8% of those who left vs. 3.2% who did not had amph use;
p  =  0.48
Non-significant
n  =  37
Kumar 2016 Long-itudinal 2012–2015 Little Rock, AR, US; outpatient bup tx program in university medical center SUD tx clinic Adult patients initiating bup Relapse prevention groups and individual CBT required 113 Amph use at initiation (UDS) Discontinuation within 90 days after initiation Logistic regression Demographics, other substance use, pain, physical or emotional neglect (2 models) Adj. for physical neglect: aOR  =  5.37 (95% CI 0.60–48.34); adj. for emotional neglect: aOR  =  4.53 (95% CI 0.50–41.01) Non-significant
n  =  13
Logan 2019 Long-itudinal 2016–2018 Hawaii Island, Hawaii, US; rural FQHC primary care bup tx program Patients initiating bup Individual therapy and mutual support groups required 54 Meth UD assessed at initiation (dx criteria) Retention at 3 months after initiation X2 test None No significant association (test statistic/p value not reported) Non-significant
n  =  24
Schuman-Olivier 2014 Long-itudinal 2007–2010 Boston, MA, US; outpatient bup tx program in academic community healthcare system Adult patients initiating bup Psycho-social tx (group or individual), relapse prevention group required 294 Amph use at initiation (UDS) Retention at 3 months and 12 months after initiation Logistic regression None 3-month: OR  =  1.31 (95% CI 0.42–4.09),
p  =  0.647
Non-significant
n  =  18 12-month: OR  =  2.10 (95% CI 0.80–5.49),
p  =  0.130
Peles 2015 Long-itudinal Tel Aviv: 1993–2013 Tel Aviv, Israel and Las Vegas, Nevada, US; methadone tx programs Adult patients initiating methadone Individual therapy (both clinics): group therapy (required Tel Aviv; encouraged Las Vegas) Tel Aviv: 306 Amph use during tx (UDS) Retention at 6 months after initiation Fisher’s exact test None No significant association (test statistic/p value not reported) Non-significant
Las Vegas: 2000–2014 Las Vegas: 190 Tel Aviv n  =  6
Las Vegas n  =  12
Pettes 2010 Long-itudinal 2005–2008 Vancouver, Canada; community survey Adult PWID with HIV reporting methadone tx 248 “Frequent” meth use in past 6 months (self-report; repeated measure) Time to discontinuation (reported having discontinued during past 6 months) Cox PH model None No significant association (measure/p value not reported) Non-significant
n  =  12 at baseline
Proctor 2015 Long-itudinal 2009–2011 US; methadone tx programs operated by a large health care provider (various locations) Adult patients initiating methadone 1644 Amph use at initiation and 6 month f/u (UDS) Discontinuation before 6 months and before 1 year after initiation Logistic regression Demographics, social factors, dose 6-months: aOR  =  1.57 (95% CI 0.92–2.69) for intake amph Non-significant
n  =  178 at initiation; 41 at 6 months 12-months: aOR  =  1.61 (95% CI 0.50–5.24) for intake amph; aOR  =  2.91 (0.84–10.12) for 6-month amph
Smyth 2018 Long-itudinal 2000–2016 Dublin, Ireland; youth OUD tx program Adolescent patients (<  18.5 years) initiating methadone or bup Tx involved counseling, family therapy (in some cases) 120 Amph use in past month at initiation (self-report) Retention until month 12 after initiation Fisher’s exact test; Calculated crude OR None Fisher’s exact test p  =  0.45; OR  =  1.9 (95% CI 0.5–7.7) Non-significant
n  =  9
Manhapra 2017 Long-itudinal 2011–2015 US; national VA VA patients with OUD who initiated bup in FY 2012 3151 Amph UD during FY 2012 (dx codes, abuse/dependence) Duration of tx (categorical) based on rx fills Calculated RRs (ref group: 0–30 days) None 31–365 days: RR  =  1.51
1–3 years: RR  =  1.31
> 3 years: RR  =  1.10
No statistical test reported
n  =  199
Manhapra 2018 Long-itudinal 2010–2014 US; national insurance claims data Commercially-insured adults with OUD who initiated bup in FY 2011 16,190 Amph UD during FY 2011 (dx codes, abuse or dependence) Duration of tx (categorical) based on rx fills Calculated RRs (ref group: 0–30 days) None 31–365 days: RR  =  0.9
1–3 years: RR  =  0.7
> 3 years: RR  =  0.2
No statistical test reported
n  =  106
White 2014 Long-itudinal 2011–2013 Washington, DC, US; private non-profit methadone tx program Adult patients receiving methadone Counseling group required; 12-step/mutual aid groups encouraged 604 Amph use during Aug 1-Nov 1, 2011 (UDS) Discontinuation before Jan 2013 Compared %s across groups None 3% of those who discontinued vs. 0.8% of those who did not had amph use No statistical test reported
n  =  7
  1. aHR adjusted hazard ratio; amph amphetamine; aOR adjusted odds ratio; bup buprenorphine; CBT cognitive behavioral therapy; CI confidence interval; dx diagnostic; FQHC federally qualified health center; f/u follow-up; FY fiscal year; GEE generalized estimating equation; KM Kaplan–Meier; naltrex naltrexone; meth methamphetamine; MOUD medications for opioid use disorder; OR odds ratio; OUD opioid use disorder; PH proportional hazards; PWID people who inject drugs; PWUD people who use drugs; RCT randomized controlled trial; ref reference; RR risk ratio; rx prescription; SUD substance use disorder; tx treatment; UD use disorder; UDS urine drug screen; US United States; VA Veterans Health Administration
  2. aIncluded if paper clearly described that study participants received or were offered services
  3. bA detailed description of covariates is provided in Appendix 2: Table 5
  4. cCrude measures of association are only presented alongside adjusted measures if there was a difference in statistical significance; p values and/or 95% CIs are presented when they were reported
  5. dStudy also examined cumulative retention, however we were unable to interpret these results based on the description of these analyses