Effectiveness of MAT programs in retaining participants in treatment in low- and middle-income countries (LMIC)

In a systematic review investigating changes in retention over time for participants in buprenorphine and methadone programs in LMIC, retention was measured for participants by length of follow-up, type of medication-assisted treatment (MAT) and treatment dosage. It was found that in LMIC: 

• Overall average retention after 12 months was 54.3% (95% CI = 46.2, 63.7%). 
• Overall average retention was moderately good for both buprenorphine (48.3%, 95% CI = 22.1, 74.6%) and methadone (56.6%, 95% CI = 45.9%, 67.3%) after 12 months of treatment. 
• Among programs using methadone there was no statistically significant difference in average retention by dosage level, and the 10 highest and lowest dosage programs obtained similar average retention levels after 12 months.

These results are comparable to average retention rates seen among MAT participants in high-income countries. The study demonstrates the effectiveness of MAT in LMIC, underscoring that there is no justification for delaying its broader implementation in these settings.