Couples Coping Through Deployment: Findings From a Sample of National Guard Families

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140037/1/jclp22487.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/140037/2/jclp22487_am.pd

Dropout rates of in‐person psychosocial substance use disorder treatments: a systematic review and meta‐analysis

Background and Aims: Relapse rates for psychosocial substance use disorder (SUD) treatments are high, and dropout is a robust predictor of relapse. No meta-analyses have assessed dropout rates in studies of psychosocial SUD treatment. The objective of this meta-analysis, therefore, was to estimate average dropout rates of in-person psychosocial SUD treatment and evaluate potential moderators of this outcome. Design: A comprehensive meta-analysis of dropout rates of studies of in-person psychosocial SUD treatment. Studies included RCTs and cohort studies. Participants/Cases: 151 studies, 338 study arms, and 299 dropout rates including 26,243 participants. Measurements: Databases were searched for studies of SUD treatment that included an in-person-facilitated psychosocial component. Meta-analyses and meta-regressions were conducted to estimate dropout rates and identify moderators of dropout, including 22 participant characteristics, two facilitator characteristics, and 15 treatment characteristics. Pooled estimates were calculated with random-effects analyses accounting for the hierarchical structure of study arms nested within studies. Findings: The average dropout rate across all studies and study arms was 30.42%(95% CI[27.22,33.83], 95% PI[6.25,74.15]) with substantial heterogeneity (I2=93.7%, p<0.0001). Studies including a higher percentage of African Americans and lower-income individuals were associated with higher dropout rates. At intake, a greater percentage of heroin use days and cigarettes/day were associated with lower dropout rates, whereas heavier cocaine use was associated with higher dropout rates. Programs characterized by more treatment sessions and greater average session length were associated with higher dropout rates. Dropout rates were highest for studies targeting cocaine, methamphetamines, and major stimulants (broadly defined), and lowest for studies targeting alcohol, tobacco, and heroin, though there were few studies on methamphetamines, major stimulants, and heroin. Facilitator characteristics were not associated with dropout. Conclusions: Approximately 3 of 10 participants drop out of in-person psychosocial SUD treatment studies. There was wide variability in reported dropout rates, and several moderators of this outcome were identified. Additional research is needed to test interactions of moderators to potentially decrease dropout