Using ADAPT‐ITT framework to tailor evidence‐based interventions for addressing methamphetamine use among methadone patients in Vietnam

Abstract

IntroductionMethamphetamine use threatens positive treatment outcomes in substance use and HIV, for people with opioid use disorders (POUD) in many countries. This paper describes the adaptation of four evidence‐based interventions (EBI) (motivational interviewing, contingency management, Matrix group model and SMS text messaging) for treating methamphetamine use among POUD receiving methadone maintenance therapy in Vietnam.MethodsFollowing the ADAPT‐ITT (Assessment‐Decision‐Administration‐Production‐Topical experts‐Training‐Testing) framework, we conducted 16 focus group discussions with POUD (n = 25) and providers (n = 22) at four methadone clinics in two largest cities (Hanoi in the North, Ho Chi Minh City in the South) to assess patterns of methamphetamine use and to get feedback on proposed EBIs. The proposed EBIs were properly adapted and used to train providers in two of the four methadone clinics. The revised EBIs were tested over 12 weeks among 42 POUD on methadone who use methamphetamine. Post‐intervention feedback served to fine‐tune the revised EBIs.ResultsInsights about patterns of methamphetamine use suggested that EBIs should focus on different triggers to methamphetamine use among POUD receiving methadone treatment in the two cities. All EBIs should emphasise family‐related topics to build a strong motivation for treatment. Participants suggested when, where and how each EBI should be delivered. Most participants were satisfied with the adapted EBIs. Limited human resources at methadone clinics might hinder implementation of the adapted EBIs.Discussion and ConclusionsWe successfully completed the adaptation of EBIs for POUD who use methamphetamine on methadone in Vietnam. The pilot testing of the adapted EBIs demonstrated feasibility and acceptability.Trial registration: NCT04706624. Registered 13 January 2021. https://clinicaltrials.gov/ct2/show/NCT04706624.

Should contingency management protocols and dissemination practices be modified to accommodate rising stimulant use and harm reduction frameworks?

“…For example, Hirchak and colleagues presented the elements of CM sessions more holistically when implementing the intervention in American Indian and Alaska Native communities while retaining the core session elements [83]. are under way, and show that CM can be implemented successfully when cultural context is considered and addressed [98,101].…”

“…Despite these barriers, efforts to adapt and implement CM in some countries (e.g. Vietnam) are under way, and show that CM can be implemented successfully when cultural context is considered and addressed [98, 101].…”