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Open Access 01-12-2024 | Research

Predictors of cocaine use disorder treatment outcomes: a systematic review

Authors: Alba Palazón-Llecha, Beatriz Caparrós, Joan Trujols, Santiago Duran-Sindreu, Francesca Batlle, Mercè Madre, Núria Mallorquí-Bagué

Published in: Systematic Reviews | Issue 1/2024

Abstract

Background

Psychosocial approaches are the first-line treatments for cocaine dependence, although they still present high dropout and relapse rates. Thus, there is a pressing need to understand which variables influence treatment outcomes to improve current treatments and prevent dropout and relapse rates. The aim of this study is to explore predictors of treatment retention and abstinence in CUD.

Methods

This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We searched three databases—PubMed, PsychINFO and Web of Science—for randomized clinical trials (RCTs) published in English and Spanish from database inception through April 1, 2023. We selected all studies that met the inclusion criteria (adults aged ≥ 18, outpatient treatment, CUD as main addiction, and no severe mental illness) to obtain data for the narrative synthesis addressing cocaine abstinence and treatment retention as main outcome variables. After data extraction was completed, risk of bias was assessed using the Cochrane risk-of-bias tool for randomized trials (RoB-2).

Results

A total of 566 studies were screened, and, of those, 32 RCTs were included in the synthesis. Younger age, more years of cocaine use, and craving levels were significant predictors of relapse and treatment dropout. Fewer withdrawal symptoms, greater baseline abstinence, greater treatment engagement, and more self-efficacy were all predictors of longer duration of abstinence. The role of impulsivity as a predictor of CUD is unclear due to conflicting data, although the evidence generally suggests that higher impulsivity scores can predict more severe addiction and withdrawal symptoms, and earlier discontinuation of treatment.

Conclusion

Current evidence indicates which variables have a direct influence on treatment outcomes, including well-studied cocaine use-related variables. However, additional variables, such as genetic markers, appear to have a high impact on treatment outcomes and need further study.

Systematic review registration

This systematic review is registered at PROSPERO (ID: CRD42021271847). This study was funded by the Spanish Ministry of Science, Innovation and Universities, Instituto Carlos III (ISCIII) (FIS PI20/00929) and FEDER funds and Fundació Privada Hospital de la Santa Creu i Sant Pau (Pla d’acció social 2020).

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Title: Predictors of cocaine use disorder treatment outcomes: a systematic review
Authors: Alba Palazón-Llecha
Beatriz Caparrós
Joan Trujols
Santiago Duran-Sindreu
Francesca Batlle
Mercè Madre
Núria Mallorquí-Bagué
Publication date: 01-12-2024
Publisher: BioMed Central
Published in: Systematic Reviews / Issue 1/2024
Electronic ISSN: 2046-4053
DOI: https://doi.org/10.1186/s13643-024-02550-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Predictors of cocaine use disorder treatment outcomes: a systematic review

Abstract

Background

Methods

Results

Conclusion

Systematic review registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Systematic review registration

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