Thuong Nong, Dominic Hodgkin, Nguyen Bich Diep, Victor Capoccia, Constance Horgan, Hoang Dinh Canh, Giang Le
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引用次数: 0
Abstract
Background: Methadone maintenance treatment (MMT) is an effective treatment for opioid use disorders, yet patient adherence and retention remain challenges in many countries. To address this, Vietnam piloted a take-home methadone program in 21 clinics across three northern provinces.
Methods: Using a stepped-wedge design, the study evaluated the impact of this take-home program on treatment adherence among 500 MMT patients who were eligible for take-home methadone in 12 pilot clinics. We used T-tests and Poisson regression models to compare patients' treatment adherence between take-home and in-person dosing periods, and conducted sensitivity analyses to assess the robustness of the results.
Results: The results indicated a significant improvement in adherence during take-home months. Joining the take-home program is associated with a reduction in methadone doses missed in a month by approximately 60%. Each additional month in the program is associated with a further 11% decrease in missed doses. Sensitivity analysis supports this finding. Each additional month in the program is also associated with a reduction in the number of times missing five consecutive doses in a month by 12.3%, but no association was found between take-home and the outcome. The sensitivity analysis found a significant negative association between the likelihood of missing five consecutive doses and the patient's continued participation in the take-home program until the last month of data collection.
Conclusion: The findings underscore the effectiveness of the take-home methadone policy in enhancing patient adherence, with greater benefits observed over extended participation.
期刊介绍：
Harm Reduction Journal is an Open Access, peer-reviewed, online journal whose focus is on the prevalent patterns of psychoactive drug use, the public policies meant to control them, and the search for effective methods of reducing the adverse medical, public health, and social consequences associated with both drugs and drug policies. We define "harm reduction" as "policies and programs which aim to reduce the health, social, and economic costs of legal and illegal psychoactive drug use without necessarily reducing drug consumption". We are especially interested in studies of the evolving patterns of drug use around the world, their implications for the spread of HIV/AIDS and other blood-borne pathogens.
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