A Meta-Analysis on the Effect of Depression on Adherence to Medication for Opioid Use Disorder

Abstract

Objective: U.S. Food and Drug Administration (FDA)-approved medications for Opioid Use Disorder (MOUD) effectively reduce opioid cravings, use, relapse, and overdose. However, adherence to MOUD is a significant challenge. Depression relates to poorer adherence across several medical conditions and may be a prime factor relating to poor MOUD adherence. The goal of this meta-analysis is to quantify the relationship between depression and MOUD adherence and to identify moderators of this association. Methods: A systematic literature search was conducted using PsycINFO, PubMed, Embase, and Cumulative Index of Nursing and Allied Health Literature [CINAHL] databases. Pearson’s r was used for the effect size statistic. A random effects model was utilized for all effect size analyses. Results: Nine studies met eligibility criteria, with a total of 3493 participants. Higher baseline depressive symptoms were found to predict greater prospective adherence to MOUD (r = 0.130, 95% CI: 0.060–0.199, p