Evaluating comparative effectiveness of psychosocial interventions for persons receiving opioid agonist therapy for opioid use disorder: protocol for a systematic review

Danielle B Rice; Brian Hutton; Patricia Poulin; Beth A Sproule; Dianna Wolfe; David Moher; Kednapa Thavorn; Gary Garber; Sheena Taha; Amy Porath; Melanie Willows; Leila Esmaeilisaraji; Fatemeh Yazdi; Beverley Shea; Becky Skidmore; Kimberly Corace

doi:10.1136/bmjopen-2018-023902

Evaluating comparative effectiveness of psychosocial interventions for persons receiving opioid agonist therapy for opioid use disorder: protocol for a systematic review

BMJ Open. 2018 Oct 18;8(10):e023902. doi: 10.1136/bmjopen-2018-023902.

Authors

Danielle B Rice^#^{1

2}, Brian Hutton^#^{1

3}, Patricia Poulin^{1

4

5}, Beth A Sproule^{6

7}, Dianna Wolfe¹, David Moher^{1

3

8}, Kednapa Thavorn^{1

3}, Gary Garber^{1

3

9}, Sheena Taha¹⁰, Amy Porath¹⁰, Melanie Willows^{11

12}, Leila Esmaeilisaraji¹, Fatemeh Yazdi¹, Beverley Shea¹, Becky Skidmore¹, Kimberly Corace^{1

12

13

14}

Affiliations

¹ Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
² Department of Psychology, McGill University, Montreal, Quebec, Canada.
³ School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.
⁴ Faculties of Social Sciences and Medicine, University of Ottawa, Ottawa, Ontario, Canada.
⁵ Pain Clinic, Ottawa Hospital, Ottawa, Ontario, Canada.
⁶ Department of Pharmacy, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
⁷ Leslie Dan Faculty of Pharmacy and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
⁸ Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
⁹ Public Health Ontario, Toronto, Ontario, Canada.
¹⁰ Canadian Center on Substance Use and Addiction, Ottawa, Ontario, Canada.
¹¹ Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
¹² Substance Use and Concurrent Disorders Program, The Royal Ottawa Mental Health Centre, Ottawa, Ontario, Canada.
¹³ Department of Psychiatry, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
¹⁴ Institute of Mental Health Research, University of Ottawa, Ottawa, Ontario, Canada.

^# Contributed equally.

Abstract

Introduction: The opioid crisis has resulted in increasing rates of death caused by problematic opioid use. Current clinical guidelines recommend that individuals with persons with opioid use disorder (OUD) receive pharmacological (eg, opioid agonist therapy) and psychosocial (eg, cognitive behavioural therapy) therapy; however, the best combination of pharmacologic and psychosocial components is not known. Our objective of the planned study is to conduct a comprehensive systematic review to assess the relative benefits of psychosocial interventions as an adjunct to opioid agonist therapy among persons with OUD.

Methods and analysis: A comprehensive search for randomised controlled trials published in English or French will be conducted from database inception to March 2018. The search will be conducted in MEDLINE and translated for Embase, PsycINFO and the Cochrane Central Register of Controlled Trials. Two independent reviewers will screen, extract and assess risk of bias of eligible articles. Primary outcomes of interest will be treatment retention and opioid use (based on urinalysis results). Secondary outcomes will include self-reported opioid use, abstinence from illicit drugs, adherence to psychosocial therapy and opioid agonist therapy, risk for sexually transmitted disease, risk for blood borne pathogens, changes in mental health symptoms (eg, depression), measures of craving and changes in patients' quality of life and relevant adverse events. If sufficient data and adequate homogeneity exists, network meta-analyses (NMA) will be performed.

Ethics and dissemination: This will be the first systematic review to incorporate NMA to compare psychosocial treatments used as an adjunct to opioid agonist therapy for OUD. Results of this review will inform clinical management of persons with OUD.

Trial registration number: CRD42018090761.

Keywords: addiction medicine; network meta-analysis; opioid use disorder; pharmacological interventions; psychosocial interventions; systematic review.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Analgesics, Opioid / therapeutic use*
Cognitive Behavioral Therapy / standards*
Female
Humans
Male
Middle Aged
Network Meta-Analysis
Opioid-Related Disorders / psychology
Opioid-Related Disorders / therapy*
Quality of Life
Randomized Controlled Trials as Topic
Research Design
Systematic Reviews as Topic*
Treatment Adherence and Compliance / psychology*

Substances

Analgesics, Opioid

Grants and funding

397976/CIHR/Canada