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

Abstract

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.

Persistence in the Methadone Maintenance Program and Its Relationship with the Medication Regimen Complexity Index in Opioid-Dependent Patients

“…Regarding the bibliographic search, there are numerous and varied studies [24][25][26][27][28][29][30][31][32][33][34][35][36] in the literature from different geographical areas, mainly Asian, Canadian and American, from different healthcare settings, mainly involving outpatients in detoxification clinics and community pharmacies, that investigate different issues related to adherence to methadone maintenance treatment (MMT). However, the main limitation of these studies is that they interchangeably express adherence or retention to MMT or MMP, the latter including interventions beyond the mere collection of daily methadone doses.…”

Perceptions and Attitudes Toward COVID-19-Related National Response Measures of Vietnamese: Implications for Pandemic Prevention and Control

“…As being aware of challenges ahead regarding limited resources and healthcare capacities ( 31 ), the Government of Vietnam had implemented various mandatory measures in the early phase of the epidemic to “flattening the curve” ( 32 ). It is necessary for the government to have time for preparing a possible upsurge in the number of COVID-19 cases and forecasting the pandemic peak in the next stages ( 13 , 33 , 34 ).…”

“…Findings from our study indicated a significantly high agreement about the importance of response measures that the Government performed during the epidemic. This phenomenon can be explained that along with the role of the Government's leadership, the transparency in epidemic information and the great involvement of mass media were critically important in developing the beliefs of the community in the Government's actions, and the importance of changing behaviors such as wearing masks, good hygiene, social distancing, or compulsory quarantine ( 32 , 35 , 36 ). Our study implied a high acceptance and feasibility of these measures if they had to be performed in the future.…”

A community approach to promote healthcare services for people living with HIV who use drugs in Vietnam

“…31,32 Poor relationships with service providers and insufficient information about treatment services contribute to suboptimal treatment adherence and retention among Vietnamese PLHWUD. 33–36 Comprehensive services and support from commune health workers (CHW) have been suggested as vital ingredients in improving Vietnam’s drug- and HIV-related service satisfaction levels. 37–39…”

“…31,32 Poor relationships with service providers and insufficient information about treatment services contribute to suboptimal treatment adherence and retention among Vietnamese PLHWUD. [33][34][35][36] Comprehensive services and support from commune health workers (CHW) have been suggested as vital ingredients in improving Vietnam's drug-and HIVrelated service satisfaction levels. [37][38][39] To strengthen community capacity in providing accessible treatment services for PLHWUD, our team developed and implemented an intervention program in Vietnam to equip CHW with communication skills and tools to motivate PLHWUD in the community to seek and retain in healthcare services.…”