The Agency for Healthcare Research and Quality commissioned a rapid evidence review (1.6MB) on the effectiveness of interventions, to promote a broader understanding of the published literature on MAT retention among adults with opioid use disorder (OUD). The study team searched MEDLINE and the Cochrane Library from February 12, 2009, through August 20, 2019, for systematic reviews (SRs) and randomized controlled trials (RCTs). They summarized evidence for six retention intervention types and reported the following key findings from 2 SRs and 39 primary studies:

• Care setting interventions that initiated MAT in soon-to-be-released incarcerated patients improved retention following release.
• Contingency management improved retention when combined with antagonist MAT but not with agonist forms of MAT. Applicability, however, may be limited due to implementation challenges.
• Preliminary trials suggest that retention in MAT supported with health IT approaches may be no worse than in-person approaches.
• Early studies suggest no difference in retention with XR-buprenorphine in either injectable or implant formulations compared with daily buprenorphine. Studies showed conflicting results with XR-naltrexone injection compared with daily buprenorphine.
• The addition of psychosocial interventions did not improve retention; however, many studies included some form of counseling in the control groups, potentially obscuring evidence of effectiveness.