Adherence to and Retention in Medications for Opioid Use Disorder Among Adolescents and Young Adults

Viera, Adam; Bromberg, Daniel J.; Whittaker, Shannon; Refsland, Bryan M; Stanojlovic, Milena; Nyhan, Kate; Altice, Frederick L.

doi:10.1093/epirev/mxaa001

Cited by 35 publications

(17 citation statements)

References 74 publications

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“…A further possible advantage of this variable is that it considers retention as both the time elapsed between the first and last scheduled appointment and the number of sessions attended during that time. This is congruent with the claims of various authors, who point out that retention should be studied together with session attendance because it offers more information on the therapeutic process (Pulford et al., 2010 ; Viera et al., 2020 ). Furthermore, considering the effect sizes observed for the variables analyzed, we consider it important to complement the use of these indicators with the measurement of other clinical variables and the patients' quality of life.…”

Section: Discussion/conclusionsupporting

confidence: 86%

“…Adherence to appointments has received rather less attention than retention and therapeutic adherence and has been studied mainly among patients in methadone treatment programs (Austin et al., 2015 ; Viera et al., 2020 ). However, some studies have indicated that the rates of non‐attendance to appointments range between 10% and 60% (Lefforge et al., 2007 ), and that these patients present less adherence than the general population (Austin et al., 2015 ).…”

Section: Introductionmentioning

confidence: 99%

“…Despite the lack of consensus and difficulties in operationalizing retention and therapeutic adherence, the usefulness of these indicators in relation to the clinical course of patients with SUD is unquestionable (Viera et al., 2020 ). For this reason, some authors point out the need for greater methodological support for the use of these variables and the establishment of categorical thresholds associated with therapeutic success and dropout (Turner & Deane, 2016 ).…”

Section: Introductionmentioning

confidence: 99%

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Retention in treatment and therapeutic adherence: How are these associated with therapeutic success? An analysis using real‐world data

Dacosta‐Sánchez

González-Ponce

Fernández‐Calderón

et al. 2022

Int J Methods Psych Res

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Introduction:Treatment retention and adherence are used as outcomes in numerous randomized clinical trials and observational studies conducted in the addiction field. Although usual criteria are 3/6 months of treatment retention or number of sessions attended, there is not a methodological support for conclusions using these criteria. This study analyzed the usefulness of retention and adherence to predict therapeutic success.Methods: Retrospective observational study using real-world data from electronic health records of 11,907 patients in treatment diagnosed with cocaine, alcohol, cannabis and opiate use disorders or harmful use.Results: Moderate effect size relations were found between the different type of clinical discharge and months in retention (η 2 = 0.12) and proportion of attendance (η 2 = 0.10). No relationship was found with the number of sessions attended. Using cut-off points (i.e., 3 or 6 months in treatment or attending 6 therapy sessions) worsens the ability to predict the type of discharge. Discussions/Conclusion: Treatment retention and adherence are indicators moderately related to therapeutic success. Research using these indicators to assess the effectiveness of therapies should complement their results with other clinical indicators and quality of life measures.

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Section: Discussion/conclusionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Retention in treatment and therapeutic adherence: How are these associated with therapeutic success? An analysis using real‐world data

Dacosta‐Sánchez

González-Ponce

Fernández‐Calderón

et al. 2022

Int J Methods Psych Res

View full text Add to dashboard Cite

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“…However, the effectiveness of this range of interventions remains largely understudied among youth using opioids [ 14 , 23 , 24 ]. Emerging evidence also suggests that youth encounter barriers to seeking and remaining in opioid treatment services [ 26 – 28 ]. For instance, in the context of MOUD, recent studies have shown that youth experience barriers at individual (e.g.…”

Section: Introductionmentioning

confidence: 99%

“…family support; stigma), and institutional-levels (e.g. age-based policies; wait times; prescriber availability) [ 26 – 28 ]. These barriers may support explanation of the relatively low rate of MOUD uptake and long-term engagement among youth [ 15 , 29 – 31 ].…”

Section: Introductionmentioning

confidence: 99%

Improving Treatment Together: a protocol for a multi-phase, community-based participatory, and co-design project to improve youth opioid treatment service experiences in British Columbia

Marchand

Tallon

Katan

et al. 2021

Addict Sci Clin Pract

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Background Opioid use is one of the most critical public health issues as highly potent opioids contribute to rising rates of accidental opioid-related toxicity deaths. This crisis has affected people from all age groups, including youth (ages 15–24) who are in a critical developmental period where the stakes of opioid use are especially high. Efforts to reduce the significant harms of opioid use have focused on the expansion of evidence-based treatments, including medications for opioid use disorder (e.g. buprenorphine). While these treatments are unequivocally life saving, recent evidence suggests that they may not align with youths’ needs. Accordingly, the ‘Improving Treatment Together’ (ITT) project has been designed with the aim to improve youths’ opioid treatment service experiences and outcomes by co-developing, implementing, and measuring youth-centred opioid use treatment service innovations. This manuscript describes the protocol for this multi-phase project. Methods The ITT project follows community-based participatory research (CBPR) and strategically integrates co-design processes throughout its four phases. Upon establishing a project partnership between national, provincial and community-based organizations, Phase 1 follows four core elements of human-centred co-design (empathy, needs identification, ideation, prototyping) in nine separate workshops. These workshops will be held in four diverse communities with youth, caregivers and service providers who have accessed or delivered opioid treatment services. Phase 1 will culminate in the co-production of opioid treatment service innovations to be considered by the project’s partners for further co-development, pilot testing, and wider implementation during the remaining phases of the project. Throughout each phase, the project will collect and analyse both qualitative and quantitative research and evaluation data to determine the project’s impact. Discussion This protocol provides a detailed description of the ITT project, with an emphasis on the project’s application of co-design and CBPR processes, the planned research and implementation procedures, and the establishment of a unique partnership. To our knowledge, this is one of the first projects to integrate these participatory processes to the design, implementation and measurement of youth-centred opioid treatment services. Embedding these processes throughout each phase of the project will strengthen the relevance and feasibility of the project’s service delivery innovations.

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Access to Medications for Opioid Use Disorder and Associated Factors Among Adolescents and Young Adults

2022

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IMPORTANCEThe ongoing overdose crisis continues to adversely affect adolescents and young adults (AYAs) and has led to numerous preventable deaths. Medications for opioid use disorder (MOUD), such as methadone, buprenorphine, and naltrexone, have the potential to reduce opioid use and associated harms; however, there are concerns that AYAs lack access to these potentially life-saving medications.OBJECTIVE To systematically review peer-reviewed literature on MOUD access and associated factors to synthesize strategies that can improve MOUD access for AYAs who use opioids. EVIDENCE REVIEWThe MEDLINE, Embase, PsycINFO, CINAHL, Sociological Abstracts, Web of Science, and Global Dissertations & Theses databases were searched from database inception until May 3, 2021. English, French, Russian, or Spanish peer-reviewed studies that evaluated the availability, prescription receipt, or initiation of MOUD were eligible for inclusion.FINDINGS This systematic review identified 37 cohort (n = 17), cross-sectional (n = 15), and qualitative (n = 5) studies that accounted for 179 785 AYAs (mean [SD] age, 24.4 [3.9] years; 148 779 [85%] were female; 67 771 [84%] were White) and examined access to methadone (30 studies), buprenorphine (26 studies), and naltrexone (10 studies). Findings reinforce concerns that AYAs were less likely to access MOUD and suggest that adolescents were more likely to receive naltrexone or buprenorphine-naloxone, which have a lower potential for abuse, in comparison with young adults. This review also identified other factors that were associated with MOUD access, including criminal justice involvement, residing in the US South, living in a limited-income area, Black race, and Hispanic or Latino ethnicity, suggesting ways in which treatment services may be improved to increase MOUD access and meet the treatment goals of AYAs.CONCLUSION AND RELEVANCE This systematic review found gaps in MOUD access between AYAs and non-AYA populations in addition to differences in MOUD access between adolescents and young adults. Considering that existing clinical guidelines recommend the use of MOUD among AYAs, and in light of the increasing number of opioid toxicity deaths, there is a need to improve MOUD access among AYAs by reducing barriers to MOUD and providing AYAs with a continuum of health and social supports alongside MOUD. Future research into ways to encourage MOUD uptake among AYAs may improve the treatment and health outcomes for this population.

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Adherence to and Retention in Medications for Opioid Use Disorder Among Adolescents and Young Adults

Cited by 35 publications

References 74 publications

Retention in treatment and therapeutic adherence: How are these associated with therapeutic success? An analysis using real‐world data

Retention in treatment and therapeutic adherence: How are these associated with therapeutic success? An analysis using real‐world data

Improving Treatment Together: a protocol for a multi-phase, community-based participatory, and co-design project to improve youth opioid treatment service experiences in British Columbia

Access to Medications for Opioid Use Disorder and Associated Factors Among Adolescents and Young Adults

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