A Literature Review Examining Primary Outcomes of Medication Treatment Studies for Opioid Use Disorder: What Outcome Should Be Used to Measure Opioid Treatment Success?
- 29 April 2020
- journal article
- review article
- Published by Wiley in The American Journal on Addictions
- Vol. 29 (4), 249-267
- https://doi.org/10.1111/ajad.13051
Abstract
Background and Objectives Medications for opioid use disorder (MOUD) reduce opioid use and overdose; however, MOUD clinical trials have used varying primary outcomes to document treatment success. We conducted a literature review to assess and critically examine the methodologies used in MOUD treatment studies. Methods Published studies in English that examined MOUD (buprenorphine, methadone, or extended‐release naltrexone) were included (N = 20). The methods and frequencies of measuring primary opioid outcomes, including urine drug tests (UDTs) and self‐report of opioid use were compared among studies. Results A total of 20 studies fit the inclusion criteria. Each study assessed opioid use; only 12 had opioid use as a primary outcome. Other primary outcomes included retention in treatment (N = 6), and two had other primary outcomes (death and opioid withdrawal symptoms). Opioid use was assessed through both self‐report and UDTs in 15 studies. Two studies did not use UDTs. Differences were found in the methods used for how opioid use, retention in treatment, self‐report of opioid use, and UDTs were measured. Discussion and Conclusions The different primary outcomes used and operational definitions in each study make comparisons between studies difficult. The use of both self‐report and UDTs for opioid use has several advantages, and if possible, researchers should use both measures. Scientific Significance This is the first review critically examining outcome measures from MOUD treatment studies. Creating a standard for opioid treatment outcomes in MOUD studies will allow for generalizable results that can inform both researchers and clinicians to better care for those with OUD. (Am J Addict 2020;00:00–00)Keywords
Funding Information
- National Institute on Drug Abuse (K02 DA032322)
This publication has 39 references indexed in Scilit:
- Retention on Buprenorphine Is Associated with High Levels of Maximal Viral Suppression among HIV-Infected Opioid Dependent Released PrisonersPLOS ONE, 2012
- Beyond drug use: a systematic consideration of other outcomes in evaluations of treatments for substance use disordersAddiction, 2011
- Assessing Drug Use during Follow-Up: Direct Comparison of Candidate Outcome Definitions in Pooled Analyses of Addiction Treatment StudiesThe American Journal of Drug and Alcohol Abuse, 2011
- Primary outcome indices in illicit drug dependence treatment research: systematic approach to selection and measurement of drug use end‐points in clinical trialsAddiction, 2011
- The SUMMIT Trial:: A field comparison of buprenorphine versus methadone maintenance treatmentJournal of Substance Abuse Treatment, 2010
- Oral naltrexone maintenance treatment for opioid dependencePublished by Wiley ,2010
- Naltrexone implants after in-patient treatment for opioid dependence: randomised controlled trialThe British Journal of Psychiatry, 2009
- Extended vs Short-term Buprenorphine-Naloxone for Treatment of Opioid-Addicted YouthJAMA, 2008
- The Timeline Followback reports of psychoactive substance use by drug-abusing patients: Psychometric properties.Journal of Consulting and Clinical Psychology, 2000
- The fifth edition of the addiction severity indexJournal of Substance Abuse Treatment, 1992