Large variation in measures used to assess outcomes of opioid dependence treatment: A systematic review of longitudinal observational studies

Wiessing, Lucas; Ferri, Marica; Darke, Shane; Simon, Roland; Griffiths, Paul

doi:10.1111/dar.12608

Cited by 15 publications

(9 citation statements)

References 129 publications

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“…An 'other' category was included to capture additional variables investigated in PLOS ONE included studies. The Maudsley Addiction Profile captures six of the eight outcome domains recommended by Wiessing et al [30]. Within the categories outlined above, where possible, relationships across studies were explored and similarities and differences highlighted.…”

Section: Summary Measures and Synthesis Of Resultsmentioning

confidence: 99%

“…A pooled analysis of individual level data from multiple cohorts, particularly those using similar methods to ascertain outcome such as prescription refill data, could also be undertaken to inform an internationally agreed definition. This would allow studies to be replicated and promote scientific progress on this question [30]. Furthermore, as noted by Brorson et al [23] future studies should provide detail on the treatment process, particularly in relation to involuntary dropout.…”

Section: Clinical Implications and Areas For Future Researchmentioning

confidence: 92%

“…Therefore, identifying risk factors for treatment dropout is essential to inform future interventions targeted at retaining patients in treatment. While we identified a large number of studies addressing this question, the overall value of the evidence was diminished due to the lack of comparability across studies arising from variability in the definition of retention or dropout [30]. There does not appear to be an accepted threshold for defining treatment dropout, studies apply various rules ranging from 30 consecutive days without a methadone or buprenorphine prescription, to 21 days, 14 days, 10 days, seven days, five days and up to two months.…”

Section: Clinical Implications and Areas For Future Researchmentioning

confidence: 99%

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Retention of patients in opioid substitution treatment: A systematic review

et al. 2020

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Background Retention in opioid substitution (OST) treatment is associated with substantial reductions in all cause and overdose mortality. This systematic review aims to identify both protective factors supporting retention in OST, and risk factors for treatment dropout. Methods A systematic search was performed using MEDLINE, Embase, PsycInfo, CINAHL and Web of Science (January 2001 to October 2019). Randomised controlled trials (RCTs) and observational cohort studies reporting on retention rates and factors associated with retention in OST were included. Factors associated with treatment retention and dropout were explored according to the Maudsley Addiction Profile. A narrative synthesis is provided. Results 67 studies were included in this review (4 RCTs and 63 observational cohort studies; N = 294,592), all assessing factors associated with retention in OST or treatment dropout. The median retention rate across observational studies was approximately 57% at 12 months, which fell to 38.4% at three years. Studies included were heterogeneous in nature with respect to treatment setting, type of OST, risk factor assessment, ascertainment of outcome and duration of follow-up. While the presence of such methodological heterogeneity makes it difficult to synthesise results, there is limited evidence to support the influence of a number of factors on retention, including age, substance use, OST drug dose, legal issues, and attitudes to OST. Conclusions Younger age, substance use particularly cocaine and heroin use, lower doses of methadone, criminal activity/incarceration, and negative attitudes to MMT appear to be associated with reduced retention in OST. A consensus definition of retention is required to allow for comparability across future studies.

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Section: Summary Measures and Synthesis Of Resultsmentioning

confidence: 99%

Section: Clinical Implications and Areas For Future Researchmentioning

confidence: 92%

Section: Clinical Implications and Areas For Future Researchmentioning

confidence: 99%

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Retention of patients in opioid substitution treatment: A systematic review

et al. 2020

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“…Given (i) the anticipated heterogeneity of outcome variables in eligible studies, (ii) the lack of a core outcome set for OAT research [ 25 – 27 ], and (iii) the fact that some of the commonly used outcome variables in OAT evaluations may not adequately reflect patient perspectives [ 28 – 30 ], we decided to not restrict our review to a few particular outcome variables. We considered the following primary outcomes: retention in treatment, access to standard OAT, quality of life or well-being and users’ satisfaction with treatment.…”

Section: Methodsmentioning

confidence: 99%

Interim opioid agonist treatment for opioid addiction: a systematic review

et al. 2022

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Background Opioid use disorder is a public health problem and treatment variability, coverage and accessibility poses some challenges. The study’s objective is to review the impact of interim opioid agonist treatment (OAT), a short-term approach for patients awaiting standard OAT, in terms of treatment retention, access to standard OAT, quality of life and satisfaction with treatment. Method We conducted a systematic review searching MEDLINE, EMBASE, PsycINFO, and CENTRAL up to May 2020. Due to variability between studies and outcome measurements, we did not pool effect estimates and reported a narrative synthesis of findings rating their certainty according to GRADE. Results We identified 266 unique records and included five randomized trials with some limitations in risk of bias and one observational study limited by selection bias. The studies assessed similar approaches to interim OAT but were compared to three different control conditions. Four studies reported on treatment retention at 4 months or less with no significant differences between interim OAT and waiting list or standard OAT. Two studies reported treatment retention at 12 months with no differences between interim OAT and standard OAT. Two trials assessed access to standard OAT and showed significant differences between interim OAT and waiting list for standard OAT. We rated the quality of evidence for these outcomes as moderate due to the impact of risk of bias. Data on quality of life or satisfaction with treatment was suboptimal. Conclusions Interim OAT is likely more effective than a waiting list for standard OAT in access to treatment, and it is probably as effective as standard OAT regarding treatment retention. PROSPERO registration CRD42018116269.

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“…However, there are differences in frequency among different societies [1]. Genetic, environmental and psychological factors underlie these differences [2]. Alcohol-substance use rate is high among males, those who do not work, those who have poor success, those who have no religious beliefs, those who have divorced parents, those who have suicide attempt history [3].…”

Section: Introductionmentioning

confidence: 99%

Body image, self-esteem and social anxiety levels in individuals with alcohol and substance abuse

Aydin¹,

Evrensel²,

Ceylan³

2018

Med-Science

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Alcohol and substance addiction is a growing problem all over the world. Also, studies on understanding the causes of addiction as well as the treatment continue. Alcohol and substance addiction have genetic, environmental and psychological causes. The leading psychological cause is anxiety disorders. There are only a few studies in the literature regarding the body images, self-esteem and social anxiety levels in individuals diagnosed with alcohol and substance abuse. The rates obtained from these studies vary. This research is designed to determine the ratio in Turkish society. Thirty-five individuals hospitalized in NPİstanbul Brain Hospital with the diagnosis of alcohol and substance addiction and thirty-five healthy subjects without any addiction were compared in terms of body image, self-esteem and social anxiety levels. Self-esteem and social anxiety levels were found to be statistically significantly high in the alcohol and substance addiction group. There was no statistically significant difference between the addiction and control groups in terms of body image level. These results support that low self-esteem and high social anxiety may be among the factors predisposing to alcohol and substance addiction.

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Large variation in measures used to assess outcomes of opioid dependence treatment: A systematic review of longitudinal observational studies

Cited by 15 publications

References 129 publications

Retention of patients in opioid substitution treatment: A systematic review

Retention of patients in opioid substitution treatment: A systematic review

Interim opioid agonist treatment for opioid addiction: a systematic review

Body image, self-esteem and social anxiety levels in individuals with alcohol and substance abuse

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