Monday, July 15, 2024

High Non-Adherence Rates Among Vietnamese Methadone Maintenance Patients Highlight Need for Social Support and Interventions

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In a recent study examining methadone maintenance patients in Vietnam, researchers found that nearly half of the participants exhibited non-adherence to their treatment regimens. This high rate of non-adherence underscores the urgent need for targeted interventions to improve patient outcomes in the methadone maintenance program. Factors such as social support, income, and education emerged as key determinants in adherence, suggesting a multi-faceted approach is essential for enhancing treatment compliance.

Study Overview and Methodology

A cross-sectional study was conducted across multiple centers, involving face-to-face interviews with 600 patients to gather data on demographics and social support. Treatment characteristics and adherence information were extracted from medical records. Non-adherence was defined as missing at least one methadone dose in the past three months. The study aimed to identify the prevalence of non-adherence and its associated factors among methadone maintenance patients in Vietnam.

Key Findings

The study revealed a non-adherence rate of 45.7%. Patients who adhered to their treatment showed significantly higher social support scores compared to those who did not (p

Geographical disparities were also noted, with patients residing in Son La being 1.72 times more likely to be non-adherent compared to those in other regions (p = 0.020). Univariate analyses suggested that age, education level, family income, occupation, and opioid relapse were other significant factors affecting adherence (p

Market Access Implications

The findings have substantial implications for market access in healthcare. Enhancing social support mechanisms and improving economic conditions could facilitate better access to treatment and adherence. Additionally, addressing regional disparities by tailoring interventions to specific areas like Son La can help mitigate non-adherence rates. These measures could ensure more equitable access to methadone maintenance programs and better overall health outcomes.

• Enhancing social support and economic conditions can significantly reduce treatment non-adherence.

• Tailoring interventions to specific regions can address geographical disparities in treatment adherence.

• Multidimensional strategies involving social, economic, and educational factors are necessary for improving adherence rates.

Conclusion

The study highlights a critical issue of high non-adherence among Vietnamese methadone maintenance patients, emphasizing the need for comprehensive interventions. By addressing social support, economic stability, and regional disparities, healthcare providers can improve treatment adherence and outcomes. This research provides a foundation for developing targeted strategies to enhance the effectiveness of methadone maintenance programs in Vietnam.

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Original Article:

Harm Reduct J. 2024 Jul 3;21(1):129. doi: 10.1186/s12954-024-01040-8.

ABSTRACT

OBJECTIVE: This multicenter, cross-sectional study was conducted to investigate the prevalence of treatment non-adherence and its associated factors among methadone maintenance patients in Vietnam.

METHODS: This secondary data analysis was conducted using the data from a previous study. Six hundred patients were interviewed face-to-face to collect data on their demographic characteristics and social support. Information about the treatment characteristics and patients’ non-adherence was gathered from medical records and books monitoring their treatment process. Treatment non-adherence was defined as missing at least one methadone dose in the last three months.

RESULTS: The overall prevalence of non-adherence was 45.7%. The average social support score of patients who completely adhered to treatment was significantly higher than that of those who did not (p < 0.001). In the multivariate logistic regression model, for each one-unit increase in social support (one score), treatment time (a year), and patient’s monthly income (one million Vietnam dongs), the odds of non-adherence decreased by 28% (aOR = 0.72, 95%CI 0.59-0.88, p = 0.002), 15% (aOR = 0.85, 95%CI 0.80-0.91, p < 0.001) and 9% (aOR = 0.91, 95%CI 0.85-0.97, p = 0.004), respectively. Patients living in Son La (a mountainous province) were 1.72 times (95%CI 1.09-2.71) more likely to be non-adherent as compared to those in other areas (p = 0.020). As per univariate analyses, other associated factors could be age, education level, family monthly income, occupation, and opioid relapse (p < 0.001).

CONCLUSIONS: A high non-adherence rate was found among Vietnamese methadone maintenance patients. Interventions involving social support, occupation, income, and education are needed to improve their treatment adherence.

PMID:38961458 | DOI:10.1186/s12954-024-01040-8

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