Factors Associated with Long-Term Retention in Buprenorphine-Based Addiction Treatment Programs: a Systematic Review

Overview

Journal J Gen Intern Med

Publisher Springer

Specialty General Medicine

Date 2021 Jan 20

PMID 33469778

Citations 15

Authors

Amy J Kennedy

Charles B Wessel

Rebecca Levine

Kendall Downer

Megan Raymond

Deborah Osakue

Iman Hassan

Jessica S Merlin

Jane M Liebschutz

Affiliations

Soon will be listed here.

Abstract

Background: The average length of buprenorphine treatment for opioid use disorder is less than 6 months.

Objective: We conducted a systematic review to determine what factors were associated with longer retention in buprenorphine treatment.

Design: We searched Medline, Embase, and Cochrane Database of Systematic Reviews in February 2018. Articles were restricted to randomized controlled trials on human subjects, written in English, which contained ≥ 24 weeks of objective data on retention in buprenorphine treatment.

Main Measures: We assessed whether dose of buprenorphine, treatment setting, or co-administration of behavioral therapy was associated with retention rates.

Key Results: Over 14,000 articles were identified. Thirteen articles (describing 9 studies) met inclusion criteria. Measures of retention varied widely. Three studies compared doses of buprenorphine between 1 and 8 mg and showed significantly higher rates of retention with higher doses (p values < 0.01). All other studies utilized buprenorphine doses between 8 and 24 mg daily, without comparison. No study found a significant difference in retention between buprenorphine alone and buprenorphine plus behavioral therapy (p values > 0.05). Initiating buprenorphine while hospitalized or within criminal justice settings prior to outpatient treatment programs was significantly associated with retention in buprenorphine treatment (p values < 0.01 respectively).

Conclusions: Setting of treatment initiation and a higher buprenorphine dose are associated with improved long-term treatment retention. More objective data on buprenorphine treatment programs are needed, including a standardized approach to defining retention in buprenorphine treatment programs.

Registration: This review was registered with PROSPERO (#CRD42019120336) in March 2019.

Citing Articles

The Impact of Longitudinal Substance Use Patterns on the Risk of Opioid Agonist Therapy Discontinuation: A Repeated Measures Latent Class Analysis.

Cui Z, Karamouzian M, Law M, Hayashi K, Milloy M, Kerr T Int J Ment Health Addict. 2024; 22(6):4004-4020.

PMID: 39722780 PMC: 11666779. DOI: 10.1007/s11469-023-01098-8.

State-level racial and ethnic disparities in buprenorphine treatment duration in the United States.

Dong H, Stringfellow E, Jalali M Am J Addict. 2024; 34(1):69-74.

PMID: 39107678 PMC: 11673446. DOI: 10.1111/ajad.13638.

Outpatient-Based Opioid Treatment Engagement and Attendance: A Prospective Cohort Study of Homeless-Experienced Adults.

Fine D, Hart K, Critchley N, Chang Y, Regan S, Joyce A J Gen Intern Med. 2024; 39(15):2927-2934.

PMID: 38987479 PMC: 11576663. DOI: 10.1007/s11606-024-08916-2.

Predictability of buprenorphine-naloxone treatment retention: A multi-site analysis combining electronic health records and machine learning.

Haredasht F, Fouladvand S, Tate S, Chan M, Yeow J, Griffiths K Addiction. 2024; 119(10):1792-1802.

PMID: 38923168 PMC: 11891486. DOI: 10.1111/add.16587.

Study Protocol for Pain Self-Management and Patient-Oriented Buprenorphine Dosing for Pain and Retention in Office-Based Opioid Treatment: A Hybrid Type 1, 2 × 2 Factorial Randomized Controlled Trial.

Salay M, Edwards K, Winstanley E, Bachrach R, Bulls H, Hanmer J Subst Use Addctn J. 2024; 46(1):201-207.

PMID: 38907678 PMC: 11863306. DOI: 10.1177/29767342241261562.

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