Background and Aims

There is mounting evidence that opioid use disorder is experienced differently by people of different genders and race/ethnicity groups. Similarly, in the US access to specific medications for opioid use is limited by gender and race/ethnicity. This study aims to evaluate if gender or race/ethnicity is associated with different rates of treatment retention in the US, for each of three medications used to treat opioid use disorder.

Methods

A systematic search was conducted using PubMed, CINHAL, and PsychINFO, databases. All studies that provided a ratio of those retained in treatment at a specified time in terms of gender and/or race/ethnicity and medication were included. Variables were created to assess the effects of time in treatment, recruited sample, required attendance at concurrent psychosocial treatment, and adherence to strict rules of conduct for continuation in treatment on retention. Meta-analytical and meta-regression methods were used to compare studies on the ratio of those who completed a specific time in treatment by race/ethnicity group and by gender.

Results

Nineteen articles that provided the outcome variable of interest were found (11 buprenorphine, six methadone, and two naltrexone). Meta-analyses found that treatment retention was similar for all gender and racial/ethnic groups for all three medications. Meta-regression found that those of the African American group who were recruited into buprenorphine treatment were retained significantly longer than African Americans in buprenorphine treatment who were studied retrospectively. Also, both genders had significantly lower retention in methadone treatment when there was the additional requirement of psychosocial therapy.

中文翻译：

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美国根据药物、种族/民族和性别对阿片类药物使用障碍药物治疗保留率的系统评价和荟萃分析

背景和目标

越来越多的证据表明，不同性别和种族/民族群体对阿片类药物使用障碍的体验不同。同样，在美国，使用阿片类药物的特定药物的获取受到性别和种族/民族的限制。本研究旨在评估性别或种族/民族是否与美国不同的治疗保留率有关，用于治疗阿片类药物使用障碍的三种药物中的每一种。

方法

使用 PubMed、CINHAL 和 PsychINFO 数据库进行了系统搜索。所有提供在特定时间接受治疗的患者在性别和/或种族/民族和药物方面的比率的研究都被包括在内。创建变量以评估治疗时间的影响、招募的样本、需要同时参加心理社会治疗以及遵守严格的行为规则以继续治疗保留。元分析和元回归方法用于比较按种族/民族和性别划分的完成特定时间治疗的人的比率的研究。

结果

找到了 19 篇提供感兴趣结果变量的文章（11 篇丁丙诺啡、6 篇美沙酮和 2 篇纳曲酮）。荟萃分析发现，所有三种药物的所有性别和种族/民族组的治疗保留率相似。Meta 回归发现，被招募接受丁丙诺啡治疗的非裔美国人组的患者保留时间明显长于接受回顾性研究的非裔美国人接受丁丙诺啡治疗的时间。此外，当有额外的心理社会治疗要求时，两性在美沙酮治疗中的保留率都显着降低。