Meta-analysis of primary care delivered buprenorphine treatment retention outcomes

ABSTRACT

Background: Currently, the capacity to provide buprenorphine treatment (BT) is not sufficient to treat the growing number of people in the United States with opioid use disorder (OUD). We sought to examine participant retention in care rates of primary care delivered BT programs and to describe factors associated with retention/attrition for participants receiving BT in this setting.

Objectives: A PRISMA-guided search of various databases was performed to identify the articles focusing on efficacy of BT treatment and OUD.

Method: A systematic literature search identified 15 studies examining retention in care in the primary care setting between 2002 and 2020. Random effects meta-regression were used to identify retention rates across studies.

Results: Retention rates decreased across time with a mean 0.52 rate at one year. Several factors were found to be related to retention, including: race, use of other drugs, receipt of counseling, and previous treatment with buprenorphine.

Conclusions: While we only investigate BT through primary care, our findings indicate retention rates are equivalent to the rates reported in the specialty care literature. More work is needed to examine factors that may impact primary care delivered BT specifically and differentiate participants that may benefit from care delivered in specialty over primary care as well as the converse.

KEYWORDS:

• Buprenorphine
• opioid use disorder
• meta-analysis
• opioid crisis
• Opioid Crisis
• primary care
• Primary Care

Disclosure statement

No potential conflict of interest was reported by the author(s).

Authors’ contribution

RLC and MT conceived the study and provided material support and oversight for the study. MT,DW, RLC, and RE designed the study design. JW, NC, WA, SM, LB, PP, AG and CB collected and compiled the data. MT and DW analyzed the data. RLC, MT, DW, RE, and AR participated in the review and interpretation of study results. RLC, MT, DW, RE, and AR drafted the manuscript. All the authors have gone through the various iterations and approved the final version of the manuscript.

Availability of data and materials

Available upon request.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/00952990.2023.2251653.

Additional information

Funding

This project is supported by the National Institutes of Health- National Institute on Minority Health and Health Disparities for funding this project under the Research Centers in Minority Institutions (RCMI) [grant MD007586]. This information or content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by NIH or the U.S. Government.