SynthesisSystematic reviews2021
Retention in opioid agonist treatment: a rapid review and meta-analysis comparing observational studies and randomized controlled trials.
Synthesis in Systematic reviews, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
43 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Patient experience of opioid use disorder treatment medications: a systematic review of contemporary qualitative research.BMJ open · 2024Pooled it
- Healthcare outcomes assessed with observational study designs compared with those assessed in randomized trials: a meta-epidemiological study.The Cochrane database of systematic reviews · 2024Pooled it
- Integrating Methadone Services Into Primary Care in Ukraine: Two-Year Outcomes From a Randomized Trial.Annals of internal medicine · 2026Trial
- Opioid agonist treatment outcomes among individuals with a history of nonfatal overdose: Findings from a pragmatic, pan-Canadian, randomized control trial.The American journal on addictions · 2025Trial
- Opioid agonist therapy switching among individuals with prescription-type opioid use disorder: Secondary analysis of a pragmatic randomized trial.Drug and alcohol dependence · 2023Trial
- Characteristics of drug-involved black women under community supervision; implications for retention in HIV clinical trials and healthcare.Social work in health careTrial
- Slower motor speed as a predictor of suicide attempts in high-risk youth.Psychological medicine · 2026Article
- Buprenorphine Oral Lyophilisate for Treatment of Opioid Use Disorder: Pharmacology and Clinical Efficacy.Pharmaceuticals (Basel, Switzerland) · 2026Review
- Adapting opioid therapy: real-world analysis of switching from methadone to slow-release morphine and back amid COVID-19 supply chain disruptions.Addiction science & clinical practice · 2026Article
- Seventeen years of experience: a retrospective cohort analysis of methadone maintenance treatment program patterns in Georgia.Harm reduction journal · 2025Article
- Levomethadone Selectively Reduces Emotional Impulsivity in ASRS-Positive ADHD-OUD Patients, Independent of Dose Escalation.Journal of clinical medicine · 2025Article
- Predicting treatment retention in medication for opioid use disorder: a machine learning approach using NLP and LLM-derived clinical features.Journal of the American Medical Informatics Association : JAMIA · 2025Article
- Knowledge user involvement is still uncommon in published rapid reviews-a meta-research cross-sectional study.Research synthesis methods · 2025Article
- The psychosocial pain management to improve opioid use disorder treatment outcomes study: Protocol for a randomized controlled trial.Contemporary clinical trials · 2025Article
- Integrating an exercise program into opioid agonist therapy: a pilot study on feasibility, fitness improvements, and participation challenges.Addiction science & clinical practice · 2025Article
- Methadone Patient Access to Collaborative Treatment: Protocol for a Pilot and a Randomized Controlled Trial to Establish Feasibility of Adoption and Impact on Methadone Treatment Delivery and Patient Outcomes.JMIR research protocols · 2025Article
- Trajectories of medication for opioid use disorder and their impact on HIV testing among people who inject drugs in India: A longitudinal assessment of clinic-based data.Addiction (Abingdon, England) · 2025Article
- The hidden costs of 'free' treatment: A cross-sectional study of patient-incurred costs for daily methadone maintenance treatment in Nairobi, Kenya.PLOS mental health · 2025Article
- Evolution of the substance use landscape: Implications for contingency management.Journal of applied behavior analysis · 2025Review
- The role of recovery peer navigators in retention in outpatient buprenorphine treatment: a retrospective cohort study.Annals of medicine · 2024Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundAlthough oral opioid agonist therapies (OATs), buprenorphine and methadone, are effective first-line treatments, OAT remains largely underutilized due to low retention rates and wide variation across programs. This rapid review therefore sought to summarize the retention rates reported by randomized controlled trials (RCTs) and controlled observational study designs that compared methadone to buprenorphine (or buprenorphine-naloxone).
methodsWe searched four electronic databases (EMBASE, MEDLINE, Cochrane Central Register of Controlled Trials, CINAHL, up to April 2018) for RCTs and controlled observational studies that compared oral fixed-dose methadone to buprenorphine versus methadone (or buprenorphine-naloxone). Data were extracted separately for two different definitions of retention in treatment: (1) length of time retained in the study and (2) presence on the final day of a study. Separate random effects meta-analyses were performed for RCTs and controlled observational studies. Data from controlled observational studies where retention was measured as the length of time retained in the study were not amenable to meta-analysis.
resultsAmong 7603 studies reviewed, 10 RCTs and 3 observational studies met inclusion criteria (n = 5065) and compared fixed-dose oral buprenorphine with methadone. Across studies, the average retention rate was highly variable (RCTs: buprenorphine 20.0-82.5% and methadone 30.7-83.8%; observational studies: buprenorphine 20.2-78.3% and methadone 48.3-74.8%). For time period retained in the study, we observed no significant difference in treatment retention for buprenorphine versus methadone in RCTs (standardized mean difference [SMD] = - 0.07; 95% CI - 0.35-0.21, p = 0.63; quality of evidence: low). For presence on the final study day, we observed no significant difference between buprenorphine and methadone treatment retention in RCTs (risk ratio [RR] = 0.89; 95% CI 0.73-1.08, p = 0.24; quality of evidence: low) and controlled observational studies (RR = 0.75; 95% CI 0.36-1.58, p = 0.45).
conclusionMeta-analysis of existing RCTs suggests retention in oral fixed-dose opioid agonist therapy with methadone appears to be generally equal to buprenorphine (or buprenorphine-naloxone), with wide variation across studies. Similarly, a meta-analysis of three controlled observational studies indicated no difference in treatment retention although there was significant heterogeneity among the included studies. The length of follow-up did not appear to affect the retention rate. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42018104452 .
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