Cross-sectional assessments of participants’ characteristics and loss to follow-up in the first Opioid Substitution Therapy Pilot Program in Kabul, Afghanistan

Ruiseñor-Escudero, Horacio; Vu, Alexander; Wirtz, Andrea L.; Familiar‐Lopez, Itziar; Berry, Mark; Mfochive, Iliassou; Farhad, A.-S.; Tschakarjan, Senop; Wisse, Ernst; Paikan, Feda M; Burnham, Gilbert

doi:10.1186/s12954-015-0062-1

Cited by 6 publications

(26 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One explanation for failure to find many associations is that the dropout rates were low, limiting our ability to find associations. Multiple studies have found age and employment to be significant predictors of retention, [16][17][18][19][20][21][22][23][24][25][26][27] whereas we find evidence only that patients reporting that they were homemakers, retired, or students are more likely to dropout than patients who have jobs. We also found in interviews with patients who dropped out that conflicts with job schedules were an important cause of drop out, which contrasts with the quantitative association between homemakers, retired persons, or students and dropout.…”

Section: Discussioncontrasting

confidence: 75%

See 1 more Smart Citation

Association Between User Fees and Dropout from Methadone Maintenance Therapy: Results of a Cohort Study in Vietnam

Johns

Châu²,

Hanh

et al. 2018

Health Systems & Reform

View full text Add to dashboard Cite

Vietnam launched methadone maintenance therapy (MMT) in 2008 with donor funding. To expand and ensure sustainability of the program, Vietnam shifted the responsibility for financing portions of MMT to provinces and, in 2015, some provinces started collecting user fees for MMT. This study assesses the association between user fees and patient dropout using a one-year observational cohort of 1,021 MMT patients in which three of seven provinces included in the study implemented user fees. We also estimate the catastrophic payments-payments of 40% or more of nonsubsistence expenditures-associated with MMT. Box-Cox proportional hazard models were used to assess the association between user fees and patient dropout. About 85% of the cohort was actively on MMT at the end of the observation period. Of those who stopped MMT care, about 8% dropped out, 3.5% were incarcerated, 1.5% died, and 2% stopped for other reasons. The dropout hazard ratio for paying user fees compared to not paying user fees ranged from 0.70 (unadjusted, p D 0.26) to 0.29 (adjusted, p D 0.33). However, 29% of patients in provinces implementing user fees incurred catastrophic payments for MMT associated user fees and transportation, compared with 11% of patients in provinces not implementing user fees (p < 0.001). In one year of follow-up, we do not find evidence that user fees increased dropout from MMT. However, catastrophic payment rates remain a concern. This study represents an example of one type of monitoring of financial transitions; further and longer-term evaluation of user fees is needed.

show abstract

Section: Discussioncontrasting

confidence: 75%

“…We found that marital status and HIV status are associated with dropout, in keeping with previous literature. 16,17,24,26,[29][30][31] This information could help to target interventions to improve retention.…”

Section: Discussionmentioning

confidence: 99%

Association Between User Fees and Dropout from Methadone Maintenance Therapy: Results of a Cohort Study in Vietnam

Johns

Châu²,

Hanh

et al. 2018

Health Systems & Reform

View full text Add to dashboard Cite

show abstract

“…The included studies were published from 2000 to 13th August 2021. Fourteen studies were conducted in Afghanistan [29,31,41,[43][44][45][46][53][54][55][56][57][58][59], one study was with Afghan refugees in Pakistan [62], nine were in Colombia [32-38, 60, 61], ten were in Myanmar [30,39,40,42,[47][48][49][50][51][52] and one was in China and Myanmar [63]. Thirty were cross-sectional in design, four were cohort studies and one case-control study.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

“…A study in Medellin, a city in Colombia, reported that 63.4% of the sample sold drugs [35]. Between 50 and 60% of Afghanistan populations reported a history of imprisonment [41,45,57] between 4 and 20% were homeless or unstably housed across the three countries [38,42,59,62] and between 15 and 52.4% were unable to read or write in Myanmar and Afghanistan [44,46,51]. In all studies except one, the majority of the sample were male (82-100%).…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

“…Two studies in Afghanistan looked at factors associated with completion or attendance at abstinence-based drug treatment centres [43,53]. Three studies in Myanmar and Afghanistan looked at retention into opioid substitution therapy and two focused on receipt of needle/syringes at harm reduction programmes [30,42,43,45,57]. One study in Colombia and three in Myanmar focused on use of HIV testing and treatment [38,39,47,50].…”

Section: Harm Reduction Drug Treatment and Hiv/hcv Testing And Treatmentmentioning

confidence: 99%

See 1 more Smart Citation

Determinants of health among people who use illicit drugs in the conflict-affected countries of Afghanistan, Colombia and Myanmar: a systematic review of epidemiological evidence

O’Brien

Jaramillo²,

Roberts³

et al. 2022

Confl Health

View full text Add to dashboard Cite

Background Afghanistan, Colombia and Myanmar are the world’s leading heroin and cocaine producers and have also experienced prolonged periods of armed conflict. The link between armed conflict and drug markets is well established but how conflict impacts on the health and social determinants of people who use drugs is less clear. The aim was to investigate health outcomes and associated factors among people who use illicit drugs in Afghanistan, Colombia and Myanmar. Methods We conducted a systematic review searching Medline, EMBASE, PsychINFO and Global Health databases using terms relating to Afghanistan, Colombia and Myanmar; illicit drug use (all modes of drug administration); health and influencing factors. Quality assessment was assessed with the Newcastle–Ottawa-Scale and papers were analysed narratively. Results 35 studies were included in Afghanistan (n = 15), Colombia (n = 9) and Myanmar (n = 11). Health outcomes focused predominantly on HIV, Hepatitis C (HCV), Hepatitis B and sexually transmitted infections (STIs), with one study looking at human rights violations (defined as maltreatment, abuse and gender inequality). Drug use was predominantly injection of heroin, often alongside use of amphetamines (Myanmar), cocaine and cocaine-based derivatives (Colombia). Only one study measured the effect of a period of conflict suggesting this was linked to increased reporting of symptoms of STIs and sharing of needles/syringes among people who inject drugs. Findings show high levels of external and internal migration, alongside low-income and unemployment across the samples. External displacement was linked to injecting drugs and reduced access to needle/syringe programmes in Afghanistan, while initiation into injecting abroad was associated with increased risk of HCV infection. Few studies focused on gender-based differences or recruited women. Living in more impoverished rural areas was associated with increased risk of HIV infection. Conclusions More research is needed to understand the impact of armed-conflict and drug production on the health of people who use drugs. The immediate scale-up of harm reduction services in these countries is imperative to minimize transmission of HIV/HCV and address harms associated with amphetamine use and other linked health and social care needs that people who use drugs may face.

show abstract

Adherence to and Retention in Medications for Opioid Use Disorder Among Adolescents and Young Adults

Viera

Bromberg

Whittaker

et al. 2020

Epidemiologic Reviews

View full text Add to dashboard Cite

The volatile opioid epidemic is associated with higher levels of opioid use disorder (OUD) and negative health outcomes in adolescents and young adults. Medications for opioid use disorder (MOUD) demonstrate the best evidence for treating OUD. Adherence to and retention in MOUD among adolescents and young adults, however, is incompletely understood. This systematic review examines the state of the literature regarding the association of age with adherence to and retention in MOUD using methadone, buprenorphine, or naltrexone among persons aged 10 to 24 along with related facilitators and barriers. The research team searched for all studies of MOUD that examined adherence, retention, or related concepts as an outcome variable where the sample included adolescents or young adults. Search criteria generated 10,229 records, which, after removing duplicates and conducting title/abstract screening, yielded 587 studies for full-text review. Ultimately, 52 articles met inclusion criteria for abstraction and 17 were selected for qualitative coding and analysis. This review found younger age to be consistently associated with shorter retention in the published literature, although the overall quality of included studies was low. Several factors at the individual, interpersonal, and institutional levels, such as concurrent substance use, MOUD adherence, family conflict, and MOUD dosage and flexibility, were seen as playing a role in MOUD retention among adolescents and young adults. This review highlights how MOUD providers can tailor treatment to increase retention of adolescents and young adults while pointing to the need for more research explaining MOUD adherence and retention disparities in this age group.

show abstract

Cross-sectional assessments of participants’ characteristics and loss to follow-up in the first Opioid Substitution Therapy Pilot Program in Kabul, Afghanistan

Cited by 6 publications

References 19 publications

Association Between User Fees and Dropout from Methadone Maintenance Therapy: Results of a Cohort Study in Vietnam

Association Between User Fees and Dropout from Methadone Maintenance Therapy: Results of a Cohort Study in Vietnam

Determinants of health among people who use illicit drugs in the conflict-affected countries of Afghanistan, Colombia and Myanmar: a systematic review of epidemiological evidence

Adherence to and Retention in Medications for Opioid Use Disorder Among Adolescents and Young Adults

Contact Info

Product

Resources

About