A review of factors associated with methadone maintenance treatment adherence and retention in Vietnam

Nong, Thuong; Hodgkin, Dominic; Trang, Nguyễn Thu; Shoptaw, Steven; Li, Michael J.; Vân, Hoàng Thị Hải; Giang, Lê Minh

doi:10.1016/j.drugalcdep.2022.109699

Cited by 5 publications

(2 citation statements)

References 42 publications

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“…However, research supports an association between various dimensions of treatment burden and retention in OAT. For instance, retention decreases when the time burden of treatment is increased, as when treatment includes mandatory counselling [ 116 ] or when clients travel more than 30 min to reach their clinic [ 117 ].…”

Section: Discussionmentioning

confidence: 99%

“…The difficulty of balancing treatment and employment is widely recognized as a barrier to retention [ 36 , 118 , 119 ]. In addition to anecdotal evidence of clients leaving treatment because of work conflicts [ 117 , 120 – 123 ], a recent cohort study found that employment was a significant predictor of “sub-optimal care trajectories” in OAT [ 124 ]. Stigma is a compounding factor, as reluctance to disclose OAT may discourage clients from seeking accommodations from their employers [ 125 ].…”

Section: Discussionmentioning

confidence: 99%

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The impact of relaxing restrictions on take-home doses during the COVID-19 pandemic on program effectiveness and client experiences in opioid agonist treatment: a mixed methods systematic review

Adams,

Blawatt,

Magel

et al. 2023

Subst Abuse Treat Prev Policy

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Background The COVID-19 pandemic led to an unprecedented relaxation of restrictions on take-home doses in opioid agonist treatment (OAT). We conducted a mixed methods systematic review to explore the impact of these changes on program effectiveness and client experiences in OAT. Methods The protocol for this review was registered in PROSPERO (CRD42022352310). From Aug.–Nov. 2022, we searched Medline, Embase, CINAHL, PsycInfo, Web of Science, Cochrane Register of Controlled Trials, and the grey literature. We included studies reporting quantitative measures of retention in treatment, illicit substance use, overdose, client health, quality of life, or treatment satisfaction or using qualitative methods to examine client experiences with take-home doses during the pandemic. We critically appraised studies using the Mixed Methods Appraisal Tool. We synthesized quantitative data using vote-counting by direction of effect and presented the results in harvest plots. Qualitative data were analyzed using thematic synthesis. We used a convergent segregated approach to integrate quantitative and qualitative findings. Results Forty studies were included. Most were from North America (23/40) or the United Kingdom (9/40). The quantitative synthesis was limited by potential for confounding, but suggested an association between take-home doses and increased retention in treatment. There was no evidence of an association between take-home doses and illicit substance use or overdose. Qualitative findings indicated that take-home doses reduced clients’ exposure to unregulated substances and stigma and minimized work/treatment conflicts. Though some clients reported challenges with managing their medication, the dominant narrative was one of appreciation, reduced anxiety, and a renewed sense of agency and identity. The integrated analysis suggested reduced treatment burden as an explanation for improved retention and revealed variation in individual relationships between take-home doses and illicit substance use. We identified a critical gap in quantitative measures of patient-important outcomes. Conclusion The relaxation of restrictions on take-home doses was associated with improved client experience and retention in OAT. We found no evidence of an association with illicit substance use or overdose, despite the expansion of take-home doses to previously ineligible groups. Including patient-important outcome measures in policy, program development, and treatment planning is essential to ensuring that decisions around take-home doses accurately reflect their value to clients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The impact of relaxing restrictions on take-home doses during the COVID-19 pandemic on program effectiveness and client experiences in opioid agonist treatment: a mixed methods systematic review

Adams,

Blawatt,

Magel

et al. 2023

Subst Abuse Treat Prev Policy

View full text Add to dashboard Cite

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There goes the neighborhood? The public safety enhancing effects of a mobile harm reduction intervention

Fixler,

Jacobs,

Jones

et al. 2024

International Journal of Drug Policy

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Outcome in methadone maintenance treatment of immigrants from the former Union of Soviet Socialist Republics

Noya,

Anat,

Shaul

et al. 2024

Harm Reduct J

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Context Immigrants from the former Union of Soviet Socialist Republics (USSR) are more prevalent in Methadone maintenance treatment (MMT) in Israel than their percentage in the general population. Aims To compare their characteristics and outcomes to those of Israeli-born and other immigrant patients. Methods Retention and survival since admission (June/1993–Dec/2022) until leaving treatment (for retention), or at the end of follow-up were analyzed. Vital data was taken from a national registry. Predictors were estimated using Kaplan–Meier and Cox regression models. Results The USSR patients (N = 262) compared with other immigrants (N = 132) and Israeli-born (N = 696) were more educated (≥ 12y) (p < 0.001), admitted to MMT at a younger age (p < 0.001), following a shorter duration of opioid usage (p < 0.001). More of them ever injected drugs (p < 0.001) and ever drank alcohol (p < 0.001). One-year retention was comparable (77.2% vs. 75.6% and 72%, p = 0.2) as did opioid discontinuation in those who stayed (p = 0.2). Former USSR patients had longer cumulative retention of their first admission (p = 0.05) with comparable overall retention since first admission, and survival, although the age of death was younger. Specific origin within the former USSR found immigrants from the Russian Federation with the best outcome, and those from Ukraine as having high HIV seropositive and shorter retention. Conclusions Despite several characteristics known to be associated with poor outcomes, former USSR immigrants showed better adherence to MMT, reflected by their longer cumulative retention in their first admission, lower rate of readmissions, and a comparable survival and overall retention in treatment. An in depth study is needed in order to understand why they decease at a younger age.

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A review of factors associated with methadone maintenance treatment adherence and retention in Vietnam

Cited by 5 publications

References 42 publications

The impact of relaxing restrictions on take-home doses during the COVID-19 pandemic on program effectiveness and client experiences in opioid agonist treatment: a mixed methods systematic review

The impact of relaxing restrictions on take-home doses during the COVID-19 pandemic on program effectiveness and client experiences in opioid agonist treatment: a mixed methods systematic review

There goes the neighborhood? The public safety enhancing effects of a mobile harm reduction intervention

Outcome in methadone maintenance treatment of immigrants from the former Union of Soviet Socialist Republics

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