Table 2.
Summary of non-RCT published studies on treatment factors associated with retention in medication-assisted treatment for opiate dependence (N=17)
| First author, year, country | Design | Sample N (% Male) | Medication | Retention outcome | Retention rate |
|---|---|---|---|---|---|
| Gryczynski59, 2013, USA | Prospective cohort, MET vs BUP; secondary analysis of two RCTs | African-Americans entering MAT; 478 (65.2) | MET, BUP | In MAT at 6 months | 78.1% MET 57.7% BUP |
| Pinto60, 2010, England | Prospective cohort, MET vs BUP; all received care coordination | Requesting MAT; 361 (75.0) | MET, BUP | In MAT at 6 months | 69.6% MET 42.5% BUP |
| Bounes61, 2013, France | Prospective cohort | Treatment settings; 151 (74.0) | MET, BUP | In MAT at 12 months | 78.0% MET 26.0% BUP |
| Serpelloni62, 2013, Italy | Retrospective cohort (65 publicly-funded addiction treatment sites) | Patients in MAT in 2010; 8,145 (84.2) | MET, BUP | Days of stay during 2010 | MET: M=246.2 (SD=110.1) BUP: M=240.5 (SD=111.7) |
| Hao63, 2013, China | Prospective cohort, MET vs Jitai tablets; all received psychosocial counseling | Completed detox; 386 (84.4) | MET, Jitai tablets | In MAT at 12 months | 85.0% MET 74.3% Jitai |
| Gryczynski64, 2014, USA | Prospective cohort; secondary analysis of RCT studying counseling | African-Americans entering MAT; 297 (61.9) | BUP | In MAT at 6 months | 57.9% overall; retention associated with higher BUP dose, especially early in treatment |
| Curcio65, 2011, Italy | Quasi-experimental: MET vs BUP/NLX; 10 sites | Public outpatients; 3,812 (89.8) | MET, BUP/NLX | In MAT at 12 months | No difference: 92.5% MET 89.4% BUP/NLX |
| Miotto66, 2012, USA | Quasi-experimental: opioid treatment program (OTP), individual counseling vs primary care (PC), brief counseling vs psychosocial program (PP) with group CBT | Community sample; 94 (58.0) | BUP/NLX | In MAT at 6 months | 21.4% OTP 33.3% PC 54.5% PP |
| Gerra67, 2011, Italy | Quasi- experimental: supervised daily (SD) vs CM vs non-contingent take- home (NT); all received psychosocial treatment; 3 sites | Heroin dependent; 300 (82.0) | MET | In MAT at 12 months | 58.0% SD 74.0% CM 50.0% NT CM>SD, NT |
| Haddad68, 2012, USA | Retrospective cohort; 2 health care sites | Patients in MAT in 2007–08; 266 (69.2) | BUP | In MAT at 12 months | 61.6% overall; retention associated with during-MAT receipt of psychiatric medication and substance abuse counseling |
| Moore69, 2012, USA | Quasi-experimental: PM+weekly dispensing vs PM+3 times per week dispensing+CBT | Primary care patients; 58 (74.1) | BUP/NLX | In MAT at 3 months | Marginal difference: 68.0% PM+CBT 87.0% PM |
| Winklbaur- Hausknost70, 2012, Austria | Quasi-experimental: vouchers for attendance vs vouchers for attendance +drug free biological samples | Pregnant women in multidisciplinary care; 59 (0.0) | MET, BUP | In MAT at 1 month post-delivery | No difference: 22% attendance 10% attendance + samples |
| Coviello92, 2012, USA | Prospective cohort; 5 sites | Offenders; 61 (92.0) | Extended release injectable NTX | In MAT at 6 months | 40.0% |
| Fox93, 2012, USA | Prospective cohort | HIV+82 (72.0) | BUP | In MAT at 6 months | 56.0% |
| Fiellin94, 2011, USA | Prospective cohort | HIV+303 (67.7) | BUP/NLX | In MAT at 12 months | 49.0% |
| Apelt95, 2013, Germany | Prospective cohort | Patients who had received MAT then began BUP-NLX; 337 (76.6) | BUP/NLX | In MAT at 12 months | 57.1% overall |
| Blanken73, 2010, Netherlands | Prospective cohort; all received psychosocial, medical support | Positive responders to HAT; 149 (83.2) | MET plus heroin | In MAT at 4 years | 55.7% |
Note: Reported retention rates within studies are significantly different unless otherwise noted. BUP = buprenorphine, MET = methadone, NLX = naloxone,
NTX = naltrexone, HAT = heroin-assisted treatment