Table 2 Details from included studies examining retention in MOUD
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 |