Service providers’ adherence to methadone maintenance treatment protocol in China

Lin, Chunqing; Lan, Chiao-Wen; Li, Li; Rou, Keming

doi:10.1016/j.drugpo.2018.02.018

Cited by 9 publications

(10 citation statements)

References 31 publications

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“…Regarding health care, a previous study in MMT service found that patients without support had lower adherence rate compared with those with support. Our result was in line with other studies, which showed that positive support from MMT providers could increase adherence [39,40].…”

Section: Discussionsupporting

confidence: 93%

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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Section: Discussionsupporting

confidence: 93%

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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“…In their research the discontinuation rate was 22% which is lesser than other similar studies, which reported values ranging from 46% to 65%; the authors stated that this is thanks to the absence of troublesome legislations regarding therapeutic services. 16 In the before mentioned study performed by Lin et al, 14 21.5% of the prescribers reported that they found out the reason for patients' treatment cessation through counseling, but the reasons were not explained in the mentioned article.…”

Section: Discussionmentioning

confidence: 98%

An Investigation on the Guideline Adherence in Opioid Addiction Treatment and the Causes of Nonadherences

Morasa¹,

Haghighi

Ataei³

et al. 2021

Addictive Disorders &Amp; Their Treatment

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This study was aimed to evaluate the level of adherence to the World Health Organization and American Society of Addiction Medicine guidelines regarding opioids addiction medications and to identify the causes of nonadherence, in Hamadan. Materials and Methods:The patients' records were used to obtain data on the patients' demographics and treatment process. The adherence to the mentioned guidelines was evaluated and reasons for nonadherence were asked from physicians. Results:At the time of the study, methadone maintenance treatment (MMT) and buprenorphine maintenance treatment (BMT) were the only common opioid addiction treatments in Hamadan. The number of the cases in BMT and MMT group was 18 and 142, respectively. The rate of the treatment course accomplishment (passing 4 stages) was 4.2% for MMT and 0% for BMT. In the induction phase, the adherence rates regarding initial dosing and regular weekly visits were 66.7 and 27.8% for BMT, beside 27.5, and 60.6% for MMT. Concerning the stabilization stage, the dosage amount, dose modification, and regular visits, respectively, 41.5%, 24.6%, and 27.5% of MMT cases were performed in adherence to the guidelines, whereas adherence of dose selection for BMT was 11.1%. In the MMT elimination stage, 33.3% compliance was observed; no case of BMT had continued the treatment to this stage. No discrepancy was because of the physicians' disbelief in clinical guidelines; they were either aimed to tailor the treatment with a patient's condition or resulted from familial, sociocultural, and financial problems. Conclusions:Overall, enhancement of patients and their families' awareness about medication process appears necessary.

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“…Thirdly, a linear mixed model was built to examine the adjusted association between the stigma score and other selected variables, in which the province and clinic unit were treated as random-effects factors. We selected the independent variables of the model based on our prior knowledge about potential factors associated with service providers' stigma towards PWUD (Haug et al, 2016;Li et al, 2015;Lin et al, 2018;Ronzani et al, 2009).…”

Section: Discussionmentioning

confidence: 99%

“…For people who are addicted to substances, prejudicial attitudes and stereotypes from service providers may weaken their willingness to access healthcare, hinder adherence to treatment, and compromise health outcomes (Borders, Booth, & Curran, 2015;Chakrapani, Velayudham, Shunmugam, Newman, & Dubrow, 2014;Mburu et al, 2018). For service providers, their negative attitudes to PWUD may decrease their interaction with patients and reduce adherence to treatment protocols (Li, Wu, Cao, & Zhang, 2012;Lin, Lan, Li, & Rou, 2018). Meanwhile, the occupational burnout and fatigue of service providers may be increased as a result of working with stigmatized groups (Haug, Bielenberg, Linder, & Lembke, 2016;Morgan, Lee, & Sebar, 2015).…”

Section: Introductionmentioning

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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Service providers’ adherence to methadone maintenance treatment protocol in China

Cited by 9 publications

References 31 publications

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

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

An Investigation on the Guideline Adherence in Opioid Addiction Treatment and the Causes of Nonadherences

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

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