Quality of life and healthcare service utilization among methadone maintenance patients in a mountainous area of Northern Vietnam

Abstract

BackgroundThe expansion of methadone maintenance treatment in mountainous areas in still limited and little is known about its health impacts on drug users. This study aimed to examine health-related quality of life (HRQOL) and health care access among patients engaging in methadone maintenance treatment (MMT) in Tuyen Quang, a mountainous province in Vietnam.MethodsWe conducted a cross-sectional survey with 241 patients conveniently recruited in two MMT clinics (Son Duong and Tuyen Quang). EuroQol-5 Dimensions – 5 levels (EQ-5D-5 L) and Visual analogue scale (VAS) were employed to measure HRQOL. Multivariate logistic and tobit regressions were used to determine the factors associated with HRQOL and health care utilization.ResultsThe overall mean score of the EQ-5D index and EQ-VAS were 0.88 (SD = 0.20) and 81.8% (SD = 15.27%), respectively. Only 8.7% utilized inpatient services, and 14.9% used outpatient services. Being more highly educated, suffering acute diseases, and using health service within the last 12 months were associated with a decreased EQ-5D index. Individuals who were multiple substance abusers and those who recently had inpatient care were more likely to have a lower VAS. Older respondents, those taking their medications at the more impoverished clinic, substance abusers, and individuals who were struggling with anxiety/depression or their usual daily activities were more likely to use both inpatient and outpatient care.ConclusionsIn summary, we observed good HRQOL, but high prevalence of anxiety/depression and low rates of service utilization among MMT patients in Tuyen Quang province. To improve the outcomes of MMT services in mountainous areas, it is necessary to introduce personalized and integrative services models with counseling and interventions on multiple substance use.

Changes in quality of life and its associated factors among illicit drug users in Vietnamese mountainous provinces: a 12-month follow-up study

“…A previous study examining the health status of elderly patients using MMT reported that advanced age was related to more chronic diseases, suboptimal adherence to taking medicine schedules [41]. Older patients, especially in mountainous areas -our context, have to face problems in accessing clinics because of the geographical barriers or in performing usual activities regarding physical health [23]. In addition, we also found that participants who were workers were negatively associated with better QoL scores in the psychological dimension.…”

“…Higher QoL is closely associated with higher level of MMT adherence and higher likelihood of community reintegration via improving workability [19][20][21]. However, most of the studies were conducted in urban and rural settings, while a lack of evidence was documented in mountainous areas, where the accessibility of health care services among drug users is constrained [10,11,13,15,22,23]. Therefore, this study aimed to assess QOL, mental disorders and their associated factors amongst people using drugs over the course of 12-month MMT in Vietnamese mountainous provinces.…”

Frequency of health‐care utilization by adults who use illicit drugs: a systematic review and meta‐analysis

“…ED presentation was consistently associated with regular or recent injecting , sex work, diagnosed hepatitis C , diagnosed HIV , female sex , homelessness or unstable housing , crack cocaine or stimulant use , alcohol use , polydrug use and mental health problems .…”

Effects of Diabetic Complications on Health-Related Quality of Life Impairment in Vietnamese Patients with Type 2 Diabetes

“…The health utility index was calculated from five items of this tool by using the Vietnam crosswalk value set, with the score ranging from -0.566 to 1 [25]. This instrument has been used in previous studies in Vietnam [26][27][28][29][30][31]. Cronbach's alpha values for SF-12v2 and EQ-5D-5L were 0.77 and 0.61, respectively.…”