Report on Provider–Client Interaction From 68 Methadone Maintenance Clinics in China

Li, Li; Comulada, W. Scott; Lin, Chunqing; Lan, Chiao-Wen; Cao, Xiaobin; Wu, Zunyou

doi:10.1080/10410236.2016.1221754

Cited by 7 publications

(5 citation statements)

References 43 publications

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“…In China, drug use has been widely considered as a violation of social and cultural norms, rather than a health issue (Li, Wang, He, Fennie, & Williams, 2012). Such belief may directly lead to health professionals' stigma and discrimination towards PWUD, especially for those having higher preferences for tradition values (Boer & Fischer, 2013;Li, Comulada, Lin, Lan et al, 2017). In addition, as most MMT clients in China are intravenous PWUD who are at high risks of HIV and HCV infection, MMT providers' stigma may reflect an aggregation of the fear of contracting infectious diseases at work and prejudicial attitudes towards drug using behaviors (Li, Wang et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

Stigma towards people who use drugs: A case vignette study in methadone maintenance treatment clinics in China

Luo

Lin

Feng

et al. 2019

International Journal of Drug Policy

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Background: Drug use stigma among service providers has been recognized as a barrier to improving the accessibility and outcomes of addiction treatment. This study examined the stigmatizing attitudes towards people who use drugs (PWUD) among service providers in methadone maintenance treatment (MMT) clinics in China and its associated factors. Methods: The cross-sectional study used the baseline data of a randomized intervention trial conducted in China, and the data were collected from January 2012 to August 2013. A total of 418 MMT service providers were included in the study. Stigma towards PWUD was measured via a 10-item scale embedded in two case vignettes (PWUD and non-PWUD). The Wilcoxon signed-rank test was performed to evaluate the vignette difference for each item of the scale. The linear mixed model was used to identify the adjusted association between drug use stigma and other interested variables including demographics, professional background, and MMT knowledge of the service providers. Results: The Wilcoxon signed-rank tests showed that the participants had a higher level of stigmatizing attitudes towards PWUD than non-PWUD (p-value < 0.001 for all items of the stigma scale). The linear mixed model identified that the reception of national MMT training was associated with a lower degree of drug use stigma (estimate=−1.79; 95% CI: −3.13, −0.45; p-value = 0.009). Conclusion: The findings of the study provide evidence of the existence of drug use stigma among MMT providers in China. The expansion of national-level training and the development of stigma reduction interventions are needed to address this issue.

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Section: Discussionmentioning

confidence: 99%

Stigma towards people who use drugs: A case vignette study in methadone maintenance treatment clinics in China

Luo

Lin

Feng

et al. 2019

International Journal of Drug Policy

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“…The current MMT provider training in China primarily focuses on the pharmacological model of MMT and related policies, while client engagement and communication have not received adequate emphasis (Yunnan Institute for Drug Abuse, 2017). Insufficient communication with clients may lead to a sub-optimal quality of service and undesirable treatment outcomes (Joe et al, 2001; Li et al, 2017). In the MMT CARE intervention training, the provider-client relationship and communication were addressed in the client-centered framework, with communication skills and tools taught and practiced to assist clients in making informed decisions.…”

Section: Discussionmentioning

confidence: 99%

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

Wu²,

Liang

et al. 2019

Drug and Alcohol Dependence

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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.

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“…About 18% of participants reported good environmental health status (opportunities for recreation/leisure and do not have enough money to meet their need) above average level (good and very good). Being in MAT service provide an opportunity for the client to access reliable health-related information and skills, but also have freedom, physical safety and security (30,31). It was observed and evident that the level of trust worth among PWIDS who were on MAT services is increasing over time (32).…”

Section: Level Of Hrqolmentioning

confidence: 99%

Health-related Quality of Life Among People Who Inject Drugs on Methadone Assisted Treatment in Zanzibar, Tanzania

Haji¹,

Damian²,

Rajab³

et al. 2021

Preprint

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Background: The burden of drug use is growing rapidly in Low- and Middle-Income countries (LMICs) with access to coastlines and most major cities;Tanzania is not exception. Methadone Assisted Treatment (MAT) has a potential to reduce addiction and therefore health and quality of lives. MAT is known to improve health related quality of life and it is essential in addressing a number of drug use related challenges among People Who Inject Drugs (PWIDS). Evidence on the profiles of Health Related Quality of Life (HRQOL) among PWIDS who are in treatment programmes particualry MAT services, is scanty in Zanzibar, Tanzania, Objectives: To determine HRQOL and associated factors among PWIDS receiving MAT Services in Zanzibar, Tanzania. Methods: This was a cross-sectional study conducted in Unguja, Zanzibar from July to August 2019. A total of 376 PWIDS attending Kidongo Chekundu MAT clinic were randomly selected and enrolled in the study. Data were electronically collected using Open Data Kit (ODK) programme during face-to-face interviews with PWIDS HRQOL was measured using the WHO's Quality of Life questionnaire Descriptive and binary logistic regression analyses were used to describe and determine factors independently associated with HRQOL. Results: Of the 376 PWIDS enrolled in this study, Vast majority (92.6%) were male. The mean age of participants at enrollment was 39 (± standard deviation (SD) 8.9). Slightly more than one third (45.5%) were single, 56.4% have a secondary school education level. Slightly more than two third (82.7%) were employed, 42% reported living at Magharibi B districts. High proportion were on MAT services for more than one year (70.2%); had good adherence to MAT services (79%), and were receving 50 – 99 mg of methadodone dose per day (51.1%).The majority of PWIDS (82%) had of high HRQOL. Employed PWIDS [AOR=5.36; 95%CI (1.51, 19.04); p=0.009], and PWIDS who were in the middle wealth quintile [OR=24.15; 95%CI (2.01, 290.30); p=0.012] were more likely to have better HRQOL. Conclusion: In general, PWIDS on MAT services have good HRQOL in Zanzibar. Being employed or having better economic status among were associated with better HRQOL. To effect this there is a need to strengthen multisectoral collaborations, integrated and comprehensive MAT services within the clinic and other related areas with all relevant stakeholders so as to improve health related quality of life among PWIDS.

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Report on Provider–Client Interaction From 68 Methadone Maintenance Clinics in China

Cited by 7 publications

References 43 publications

Stigma towards people who use drugs: A case vignette study in methadone maintenance treatment clinics in China

Stigma towards people who use drugs: A case vignette study in methadone maintenance treatment clinics in China

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

Health-related Quality of Life Among People Who Inject Drugs on Methadone Assisted Treatment in Zanzibar, Tanzania

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