Effects of medication assisted treatment (MAT) for opioid use disorder on functional outcomes: A systematic review

摘要: This systematic review synthesizes evidence on the effects of Medication-Assisted Treatment (MAT) for opioid use disorder (OUD) functional outcomes, including cognitive (e.g., memory), physical fatigue), occupational return to work), social/behavioral criminal activity), and neurological balance) function. Five databases were searched from inception July 2017 identify English-language controlled trials, case control studies, cohort comparisons one or more groups; cross-sectional studies excluded. Two independent reviewers screened identified literature, abstracted study-level information, assessed quality included studies. Meta-analyses used Hartung-Knapp method random-effects models. The was using GRADE approach. A comprehensive search followed by 1411 full text publication screenings yielded 30 randomized trials (RCTs) 10 observational meeting inclusion criteria. reported highly diverse outcome measures. Only RCT rated as high quality, but several methodologically sound identified. statistical power detect differences in outcomes unclear most When compared with matched "healthy" controls no history substance (SUD), two MAT patients had significantly poorer working memory speed. One study found scored worse aggressive responding than did controls. large that users twice odds involvement an injurious traffic accident non-users. persons OUD not MAT, lower fatigue rates among buprenorphine-treated patients. No results activity other areas mixed. There few drug types. pooled analysis three RCTs a prevalence buprenorphine methadone, while meta-analysis same difference insomnia prevalence. Three focused function methadone; statistically significant memory, speed flexibility, attention, vision reported. low very low. In sum, weaknesses body prevent strong conclusions about outcomes. Rigorous would strengthen literature.