An intervention trial targeting methadone maintenance treatment providers to improve clients’ treatment retention in China

Abstract

Background: Service providers including doctors, nurses, and other healthcare professionals play an essential role in methadone maintenance treatment (MMT). This study evaluated the impact of an intervention targeting MMT providers on their clients’ treatment retention. Methods: This study was conducted in 68 MMT clinics in five provinces of China with 36 clients randomly selected from each clinic. The clinics were randomized to intervention or control condition. The MMT CARE intervention started with group sessions to enhance providers’ communication skills. The trained providers were encouraged to conduct individual sessions with clients to promote treatment engagement. The outcomes, which include client retention (main outcome) and their reception of provider-delivered individual sessions (process outcome), were measured over a 24-month period. Results: Significantly fewer intervention clients dropped out from MMT than control clients during the study period (31% vs. 41%; p < 0.0001). Dropout hazard was significantly lower in the intervention condition compared to the control condition (HR = 0.71, 95% CI: 0.57, 0.89). More intervention clients had individual sessions than control clients (93% vs. 70%; p < 0.0001). Having individual sessions was associated with a significantly lower dropout hazard (HR = 0.30, 95% CI: 0.23, 0.40). The intervention clients had a significantly lower dropout hazard than the control clients if they started the individual sessions during the first six months (HR = 0.68, 95% CI: 0.51, 0.90). Conclusions: The MMT CARE intervention focusing on provider capacity building has demonstrated efficacy in reducing clients’ treatment dropout. This study sheds light on MMT service improvement in China and other global community-based harm reduction programs.

Time to treatment initiation and retrospective analysis of antiretroviral therapy outcomes among HIV-positive methadone maintenance therapy clients in primary health-care centers, Kuantan, Pahang

“…Trained staff for counseling and intervention using motivational interviewing methods to improve adherence and knowledge had shown beneficial to start the patient on ART and increase the retention rate. [ 11 12 ] Persistent and continuous monitoring of MMT clients were crucial to make sure they remain in the program. MMT discontinuation was independently associated with the risk of ART discontinuation and ART interruption.…”

Glymphatic-System Function Is Associated with Addiction and Relapse in Heroin Dependents Undergoing Methadone Maintenance Treatment

“…The Chinese MMT program has been effective in reducing the number of injections, injection-related risk behaviors, and adversities due to HIV/HCV infection and drug-related harm among drug users [ 4 ]. However, several factors—such as low methadone dosage and concurrent use of heroin [ 5 ]—have been identified in the literature as associated with MMT dropout [ 6 , 7 ]. One-year MMT retention rates in China ranged from 30% to 86%, and most dropouts occurred within the first 12 months of the treatment [ 8 ].…”