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Article Abstract
Background: Methadone maintenance treatment (MMT) is an effective treatment for opioid use disorders, yet patient adherence and retention remain challenges in many countries. To address this, Vietnam piloted a take-home methadone program in 21 clinics across three northern provinces.
Methods: Using a stepped-wedge design, the study evaluated the impact of this take-home program on treatment adherence among 500 MMT patients who were eligible for take-home methadone in 12 pilot clinics. We used T-tests and Poisson regression models to compare patients' treatment adherence between take-home and in-person dosing periods, and conducted sensitivity analyses to assess the robustness of the results.
Results: The results indicated a significant improvement in adherence during take-home months. Joining the take-home program is associated with a reduction in methadone doses missed in a month by approximately 60%. Each additional month in the program is associated with a further 11% decrease in missed doses. Sensitivity analysis supports this finding. Each additional month in the program is also associated with a reduction in the number of times missing five consecutive doses in a month by 12.3%, but no association was found between take-home and the outcome. The sensitivity analysis found a significant negative association between the likelihood of missing five consecutive doses and the patient's continued participation in the take-home program until the last month of data collection.
Conclusion: The findings underscore the effectiveness of the take-home methadone policy in enhancing patient adherence, with greater benefits observed over extended participation.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302866 | PMC |
| http://dx.doi.org/10.1186/s12954-025-01279-9 | DOI Listing |
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