Why Participants Leave: A Qualitative Study Exploring Dropout from a Medication for Opioid Use Disorder (MOUD)...

Area of Science:

• Clinical Psychology
• Public Health
• Substance Use Research

Background:

• High dropout rates in clinical trials compromise data validity, especially for individuals with substance use and mental health disorders.
• This study focuses on a randomized trial of the Minds and Mentors Program, a Mindfulness-Based Relapse Prevention and peer support intervention for adults receiving Medication for Opioid Use Disorder (MOUD).

Purpose of the Study:

• To qualitatively examine participant dropout reasons in a clinical trial for adults with Opioid Use Disorder.
• To identify modifiable factors influencing participant retention in MOUD research.

Main Methods:

• Qualitative descriptive design utilizing semi-structured interviews with eight participants who withdrew from the study.
• Thematic analysis of transcribed interviews following Braun and Clarke's framework to identify patterns in dropout reasons.

Main Results:

• Four key themes emerged: Structural/Logistical Barriers (work, transport), Procedural Fatigue/Assessment Burden (long questionnaires), Emotional/Relational Triggers (stigma, distressing content), and Perceived Value/Program Continuity (unclear outcomes).
• Participants acknowledged the study's positive intent and staff support despite challenges.

Conclusions:

• Dropout in MOUD trials is influenced by a combination of participant circumstances and study design.
• Recommendations include flexible scheduling, hybrid participation, reduced assessment burden, trauma-informed approaches, and clear communication to enhance retention and ensure equitable research.