scispace - formally typeset
Search or ask a question
Journal ArticleDOI

Drop-out from addiction treatment: A systematic review of risk factors

TL;DR: Based on the review of studies investigating the risk factors associated with drop-out from addiction treatment published in peer-reviewed journals from 1992 to 2013, clinical recommendations include assessing cognitive functioning and personality disorders at baseline and continuous monitoring of treatment alliance.
About: This article is published in Clinical Psychology Review.The article was published on 2013-12-01. It has received 419 citations till now. The article focuses on the topics: Risk factor & Addiction.
Citations
More filters
Journal ArticleDOI
TL;DR: Results show that African Americans and Hispanics are less likely to complete a treatment episode than Whites, and that these disparities vary among users of different substances, and highlight the need for culturally appropriate treatment programs to enhance treatment program retention and associated positive post-treatment outcomes.

142 citations


Cites background or result from "Drop-out from addiction treatment: ..."

  • ...However, the majority of the treatment completion research literature involves single site studies that tend to focus on a particular drug using population (Brorson et al., 2013), which prohibits...

    [...]

  • ...However, the majority of the treatment completion research literature involves single site studies that tend to focus on a particular drug using population (Brorson et al., 2013), which prohibits direct comparisons of treatment completion rates for different substances of choice....

    [...]

  • ...Research has identified a great many factors that increase or decrease the likelihood of completing a treatment episode for a substance use disorder (Brorson et al, 2013; Craig, 1985; Stark, 1992)....

    [...]

  • ...While treatment for substance use disorders can ameliorate these consequences, particularly for those who complete appropriate treatment (Brorson et al., 2013), research indicates that African Americans and Hispanics tend to have more barriers to accessing treatment services, lower utilization…...

    [...]

  • ...For those who do receive treatment services, retention is generally a critical prognostic indicator of positive post-treatment outcomes for all client groups (Brorson et al., 2013)....

    [...]

Journal ArticleDOI
14 May 2020-PLOS ONE
TL;DR: 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.
Abstract: 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.

142 citations


Cites background from "Drop-out from addiction treatment: ..."

  • ...[23] future studies should provide detail on the treatment process, particularly in relation to involuntary dropout....

    [...]

  • ...With the exception of younger age, demographic factors were not identified as consistent risk factors [23]....

    [...]

  • ...One systematic review examined risk factors associated with dropout from addiction treatment, reporting on 122 studies which included an active psychosocial treatment between 1992 and 2013 [23]....

    [...]

Journal ArticleDOI
TL;DR: On average around 30% of participants drop out of in-person psychosocial substance use disorder treatment studies but there is wide variability, and dropout rates vary with substance being treated, characteristics of the treatment and the treated population.
Abstract: BACKGROUND AND AIMS Relapse rates for psychosocial substance use disorder (SUD) treatments are high, and dropout is a robust predictor of relapse. This study aimed to estimate average dropout rates of in-person psychosocial SUD treatments and to assess predictors of dropout. DESIGN A comprehensive meta-analysis of dropout rates of studies of in-person psychosocial SUD treatment. Studies included randomized controlled trials (RCTs) and cohort studies. SETTING Studies conducted anywhere in the world that examined SUD treatment and were published from 1965 to 2016, inclusive. PARTICIPANTS/CASES One hundred and fifty-one studies, 338 study arms and 299 dropout rates including 26 243 participants. MEASUREMENTS Databases were searched for studies of SUD treatment that included an in-person psychosocial component. Meta-analyses and meta-regressions were conducted to estimate dropout rates and identify predictors of dropout, including participant characteristics, facilitator characteristics and treatment characteristics. Pooled estimates were calculated with random-effects analyses accounting for the hierarchical structure of study arms nested within studies. FINDINGS The average dropout rate across all studies and study arms was 30.4% [95% confidence interval (CI) = 27.2-33.8 and 95% prediction interval (PI) = 6.25-74.15], with substantial heterogeneity (I2 = 93.7%, P < 0.0001). Studies including a higher percentage of African Americans and lower-income individuals were associated with higher dropout rates. At intake, more cigarettes/day and a greater percentage of heroin use days were associated with lower dropout rates, whereas heavier cocaine use was associated with higher dropout rates. Dropout rates were highest for studies targeting cocaine, methamphetamines and major stimulants (broadly defined) and lowest for studies targeting alcohol, tobacco and heroin, although there were few studies on methamphetamines, major stimulants and heroin. Programs characterized by more treatment sessions and greater average session length were associated with higher dropout rates. Facilitator characteristics were not significantly associated with dropout. CONCLUSIONS On average, approximately 30% of participants drop out of in-person psychosocial SUD treatment studies, but there is wide variability. Drop-out rates vary with the treated population, the substance being targeted, and the characteristics of the treatment.

121 citations

Journal ArticleDOI
TL;DR: There is a need to implement treatment models that more effectively address barriers to treatment retention for Medicaid beneficiaries with OUD treated with buprenorphine following treatment initiation to identify risk factors for early discontinuation.

117 citations

Journal ArticleDOI
TL;DR: Results support the contention that SUDs are more likely to be "chronic" or long term disorders than acute disorders for a substantial number of individuals, however, more longitudinal research is required.

95 citations


Cites result from "Drop-out from addiction treatment: ..."

  • ...This conjecture is consistent with the findings of previous studies where higher numbers of drop-outs corresponded to the “worst cases” (Brorson et al., 2013); yet more research is needed to confirm these results....

    [...]

References
More filters
Journal ArticleDOI
TL;DR: Moher et al. as mentioned in this paper introduce PRISMA, an update of the QUOROM guidelines for reporting systematic reviews and meta-analyses, which is used in this paper.
Abstract: David Moher and colleagues introduce PRISMA, an update of the QUOROM guidelines for reporting systematic reviews and meta-analyses

62,157 citations

Journal Article
TL;DR: The QUOROM Statement (QUality Of Reporting Of Meta-analyses) as mentioned in this paper was developed to address the suboptimal reporting of systematic reviews and meta-analysis of randomized controlled trials.
Abstract: Systematic reviews and meta-analyses have become increasingly important in health care. Clinicians read them to keep up to date with their field,1,2 and they are often used as a starting point for developing clinical practice guidelines. Granting agencies may require a systematic review to ensure there is justification for further research,3 and some health care journals are moving in this direction.4 As with all research, the value of a systematic review depends on what was done, what was found, and the clarity of reporting. As with other publications, the reporting quality of systematic reviews varies, limiting readers' ability to assess the strengths and weaknesses of those reviews. Several early studies evaluated the quality of review reports. In 1987, Mulrow examined 50 review articles published in 4 leading medical journals in 1985 and 1986 and found that none met all 8 explicit scientific criteria, such as a quality assessment of included studies.5 In 1987, Sacks and colleagues6 evaluated the adequacy of reporting of 83 meta-analyses on 23 characteristics in 6 domains. Reporting was generally poor; between 1 and 14 characteristics were adequately reported (mean = 7.7; standard deviation = 2.7). A 1996 update of this study found little improvement.7 In 1996, to address the suboptimal reporting of meta-analyses, an international group developed a guidance called the QUOROM Statement (QUality Of Reporting Of Meta-analyses), which focused on the reporting of meta-analyses of randomized controlled trials.8 In this article, we summarize a revision of these guidelines, renamed PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses), which have been updated to address several conceptual and practical advances in the science of systematic reviews (Box 1). Box 1 Conceptual issues in the evolution from QUOROM to PRISMA

46,935 citations

Journal ArticleDOI
TL;DR: PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) is introduced, an update of the QUOROM guidelines for reporting systematic reviews and meta-analyses.
Abstract: Moher and colleagues introduce PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), an update of the QUOROM guidelines for reporting systematic reviews and meta-analyses. Us...

23,203 citations

15 Aug 2006
TL;DR: In this paper, the authors discuss the implications of these problems for the conduct and interpretation of research and suggest that claimed research findings may often be simply accurate measures of the prevailing bias.
Abstract: There is increasing concern that most current published research findings are false. The probability that a research claim is true may depend on study power and bias, the number of other studies on the same question, and, importantly, the ratio of true to no relationships among the relationships probed in each scientific field. In this framework, a research finding is less likely to be true when the studies conducted in a field are smaller; when effect sizes are smaller; when there is a greater number and lesser pre-selection of tested relationships; where there is greater flexibility in designs, definitions, outcomes, and analytical modes; when there is greater financial and other interest and prejudice; and when more teams are involved in a scientific field in chase of statistical significance. Simulations show that for most study designs and settings, it is more likely for a research claim to be false than true. Moreover, for many current scientific fields, claimed research findings may often be simply accurate measures of the prevailing bias. In this essay, I discuss the implications of these problems for the conduct and interpretation of research.

5,003 citations

Journal ArticleDOI
01 Aug 2005-Chance
TL;DR: In this paper, the authors discuss the implications of these problems for the conduct and interpretation of research and conclude that the probability that a research claim is true may depend on study power and bias, the number of other studies on the same question, and the ratio of true to no relationships among the relationships probed in each scientifi c fi eld.
Abstract: Summary There is increasing concern that most current published research fi ndings are false. The probability that a research claim is true may depend on study power and bias, the number of other studies on the same question, and, importantly, the ratio of true to no relationships among the relationships probed in each scientifi c fi eld. In this framework, a research fi nding is less likely to be true when the studies conducted in a fi eld are smaller; when effect sizes are smaller; when there is a greater number and lesser preselection of tested relationships; where there is greater fl exibility in designs, defi nitions, outcomes, and analytical modes; when there is greater fi nancial and other interest and prejudice; and when more teams are involved in a scientifi c fi eld in chase of statistical signifi cance. Simulations show that for most study designs and settings, it is more likely for a research claim to be false than true. Moreover, for many current scientifi c fi elds, claimed research fi ndings may often be simply accurate measures of the prevailing bias. In this essay, I discuss the implications of these problems for the conduct and interpretation of research. It can be proven that most claimed research fi ndings are false.

4,999 citations

Trending Questions (1)
What factors contribute to early drop out from addiction treatment in Therapeutic Communities?

Cognitive deficits, low treatment alliance, personality disorder, and younger age are consistent risk factors for early drop out from addiction treatment in Therapeutic Communities.