Expanding co-payment for methadone maintenance services in Vietnam: the importance of addressing health and socioeconomic inequalities

Tran, Bach Xuan; Nguyen, Quyen Le; Nguyen, Long H.; Phan, Huong Thu Thi; Le, Huong Thi; Tran, Tho Dinh; Vu, Trang; Latkin, Carl A.

doi:10.1186/s12913-017-2405-y

Cited by 11 publications

(9 citation statements)

References 38 publications

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“…Various studies indicate the effectiveness of MMT centers in reducing the risks of addiction, e.g., to injecting drug use, and its adverse effects related to diseases such as AIDS and hepatitis (14). Considering the lack of a comprehensive study in this regard in Kermanshah province, this study attempted to evaluate the therapeutic effectiveness of MMT in reducing depression, anxiety, and quality of life among addicts.…”

Section: Discussionmentioning

confidence: 99%

Follow-up Study of Drug Use, Depression, and Anxiety Reduction and Quality of Life in Addicts on Methadone Maintenance Therapy

Almasi

Hajimoradi

Mohammadi

2019

Jundishapur J Health Sci

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Background:This study aimed to evaluate reduced drug consumption, risky behaviors, depression, and anxiety and improved quality of life in addicts on methadone maintenance therapy (MMT) at baseline and six months after therapy. Methods: In this descriptive cross-sectional study, 275 addicts were selected by a random sampling method in 2017. The data collection tools consisted of four questionnaires including a demographic information questionnaire, the Beck depression inventory questionnaire, WHOQOL-26, and Spielberger Anxiety Inventory. Data analysis was done by SPSS20 software at a confidence level of 95%. Results: Based on the obtained results, after six months, MMT efficiency was 50.5% and no cases of intravenous injection were reported. The consumption of other drugs was significantly reduced (P < 0.05). The highest prevalence of depression was observed in cannabis and opium users. Depression decreased from 85.81% to 63.27%. The mean scores of quality of life and anxiety after MMT increased to 89.6 and 20.41, respectively. The most improvement was in the physical health domain (mean score of 64.11). Conclusions:The results showed improvements in all the four domains of physical health, psychological health, social relationship, and environment and reductions in depression and anxiety.

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Section: Discussionmentioning

confidence: 99%

Follow-up Study of Drug Use, Depression, and Anxiety Reduction and Quality of Life in Addicts on Methadone Maintenance Therapy

Almasi

Hajimoradi

Mohammadi

2019

Jundishapur J Health Sci

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“…In the Vietnamese context, MMT has been proved to be effective to reduce HIV transmission [11,12]. The long-term effects of opioids (physical dependence and addiction) are reducing among patients having MMT treatment [13].…”

Section: Introductionmentioning

confidence: 99%

Treatment adherence amongst drug users attending public and private methadone maintenance clinics in a northern province of Vietnam

Lê

et al. 2020

Subst Abuse Treat Prev Policy

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Background: Methadone maintenance treatment (MMT) has been proven to be effective in improving health status and the quality of life of illicit drug users. Due to the quick expand of methadone program, socialization through co-payment service is a critical to the success of it. In Nam Dinh, Vietnam, MMT has been used in public clinics and one private clinic. Such effectiveness of this treatment has been found to depend largely on adherence to treatment. This study aims to explore the compliance rate and its influencing factors among drug users between public and private clinics in Nam Dinh province, Vietnam. Methods: A cross-sectional study was conducted on 395 participants from January to September in 2018 in three MMT clinics in Nam Dinh, Vietnam. We applied the convenience sampling technique to recruit respondents. Data on socioeconomics characteristics, MMT adherence (measured by Visual Analogue Scale-VAS) and level of social/ family support were collected. Results: 43.3% of participants reported complete adherence to the MMT program during the time of research. Significant factors affect MMT adherence among illicit drug users including family income, history of drug rejections, concurrence in drug usage, far distance from MMT clinics, and having only peer. Patients in MMT private clinic had higher complete adherence than that of public MMT (OR = 1.82, 95% CI = 1.13; 2.94). Having contacts with peer drug users associated with a higher rate of incomplete adherence (OR = 2.83, 95% CI = 1.39; 5.73). Conclusions: The findings support the establishment of private MMT clinics alongside public ones, while further researches to determine the optimal dose and ways to reduce the impact of peer drug user's influence are encouraged to be conducted.

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“…Since its first introduction in 2008, 251 MMT clinics have been established and providing treatment for over 46,000 patients [ 34 ]. The Vietnam’s MMT program has been proved to effectively contribute to the control and prevention of HIV/AIDS [ 35 – 37 ]. However, poor medication adherence poses a great challenge to health managers in the rapid expansion of MMT services in Vietnam.…”

Section: Introductionmentioning

confidence: 99%

Social and structural barriers for adherence to methadone maintenance treatment among Vietnamese opioid dependence patients

et al. 2018

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IntroductionMethadone maintenance treatment (MMT) services may reduce the risk of HIV transmission if patients completely adhere to the treatment. Identifying adherence patterns and potential related factors is vital for the sustainability of MMT program in Vietnam. This study examined social and structural factors associated with adherence to MMT among patients in different service delivery models.Materials and methodsA total of 510 patients at three MMT clinics in Hanoi were interviewed. Measures of self-reported adherence included the number of missed doses in the past 7 days and the level of adherence in the past 30 days using a visual analog scale (VAS) scoring from 0 (non-adherence) to 100 (perfect adherence). Multivariate regressions were employed to identify factors associated with non-adherence to MMT.ResultsA total of 17.7% of participants reported incomplete MMT adherence in the last 30 days and 8.3% reported missing a dose in the last seven days, respectively. Living with HIV/AIDS, poor self-care and usual activities, and disclosure of health issues to spouses or intimate partners were associated with non-adherence. Those patients with pain or depression were more likely to report better adherence. Disclosing health status to spouse/partner increased the risk of incomplete adherence, while disclosing to friends reduced the number of missed dose in the last seven days. Patients attending clinics with comprehensive services had a lower VAS score of adherence compared to those enrolling in clinics with only MMT and general health care.ConclusionsSustaining the compliance of patients to MMT is principal in the rapid expansion of this service in Vietnam. It is necessary to address the complexity of health care demands of drug users, their difficulties to be rehabilitated into workforce and society, and the stigmatization to maximize the outcomes of MMT program.

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Expanding co-payment for methadone maintenance services in Vietnam: the importance of addressing health and socioeconomic inequalities

Cited by 11 publications

References 38 publications

Follow-up Study of Drug Use, Depression, and Anxiety Reduction and Quality of Life in Addicts on Methadone Maintenance Therapy

Follow-up Study of Drug Use, Depression, and Anxiety Reduction and Quality of Life in Addicts on Methadone Maintenance Therapy

Treatment adherence amongst drug users attending public and private methadone maintenance clinics in a northern province of Vietnam

Social and structural barriers for adherence to methadone maintenance treatment among Vietnamese opioid dependence patients

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