Trends and Barriers of Medication Treatment for Opioid Use Disorders: A Systematic Review and Meta-Analysis

IF 1.2 4区社会学 Q4 SUBSTANCE ABUSE Journal of Drug Issues Pub Date : 2023-10-11 DOI:10.1177/00220426231204841

Morica Hutchison, Beth S. Russell, Abigail Leander, Nathaniel Rickles, Derek Aguiar, Xiaomei S. Cong, Ofer Harel, Adrian V. Hernandez

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引用次数: 1

Abstract

Adherence to and retention in Medication Treatment for Opioid Use Disorders (MOUD) persist. We systematically reviewed trends of USA MOUD adherence, retention, and barriers from 2011–2021. Primary outcomes were adherence to and retention in MOUD, abstinence, adverse events, and treatment barriers. Effects of inverse variance random meta-analyses were examined using proportions and 95% CIs. 28 studies (102,318 patients), 78.1% male. Adherence was 56% across all studies, highest for methadone (73%). Retention by study design was heterogeneous: case series (57%), cohorts (47%), and RCTs (70%). The most common barriers were younger age, comorbid diagnoses, daily attendance, no insurance, and transportation. Abstinence was 72%, and adverse events was 5%. There was high heterogeneity in MOUD across drug types and study designs. Our findings extend the knowledge base of MOUD treatment to describe barriers that underpin the focus on retention in care above adherence given its focus to harm reduction principles.

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阿片类药物使用障碍药物治疗的趋势和障碍:系统回顾和荟萃分析

阿片类药物使用障碍(mod)药物治疗的依从性和保留性持续存在。我们系统地回顾了2011-2021年美国mod依从性、保留率和障碍的趋势。主要结局是mod的坚持和保留、戒断、不良事件和治疗障碍。使用比例和95% ci检验反方差随机荟萃分析的效果。28项研究(102318例患者)，78.1%为男性。所有研究的依从性为56%，美沙酮最高(73%)。研究设计的保留是异质的:病例系列(57%)、队列(47%)和随机对照试验(70%)。最常见的障碍是年龄较小、合并症诊断、每日就诊、无保险和交通。禁欲率为72%，不良事件发生率为5%。在不同的药物类型和研究设计中，mod具有高度的异质性。我们的研究结果扩展了mod治疗的知识基础，描述了基于减少伤害原则的坚持治疗而不是依从性的障碍。

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来源期刊

Journal of Drug Issues SUBSTANCE ABUSE-

CiteScore

3.00

自引率

11.80%

发文量

期刊介绍： The Journal of Drug Issues (JDI) was incorporated as a nonprofit entity in the State of Florida in 1971. In 1996, JDI was transferred to the Florida State University College of Criminology and Criminal Justice, and the Richard L. Rachin Endowment was established to support its continued publication. Since its inception, JDI has been dedicated to providing a professional and scholarly forum centered on the national and international problems associated with drugs, especially illicit drugs. It is a refereed publication with international contributors and subscribers. As a leader in its field, JDI is an instrument widely used by research scholars, public policy analysts, and those involved in the day-to-day struggle against the problem of drug abuse.