Impact of Blended Treatment Literacy & Psychoeducation on Methadone Maintenance Treatment Outcomes in Yunnan, China
BACKGROUND:
Outcomes
of methadone maintenance treatment (MMT) in the management of opioid dependency can be impaired by poor adherence
and retention, concomitant drug use, poor adjustment of methadone dosage, and
low levels of awareness regarding methadone among drug users, among
other factors. This study investigated the effects of intensive blended
treatment literacy and psychoeducation on treatment compliance, methadone dose,
and heroin use among MMT clients in China.
METHODS:
A total
of 492 MMT clients who tested positive for urine morphine at least once during
a 12-week intervention period preceding the study were recruited from 16 MMT
clinics. Employing a client-centred approach, a blended treatment literacy and
psychoeducation intervention was then implemented between March and June 2014,
comprising (1) intensified methadone treatment literacy sessions; (2)
participatory goal setting; (3) continuous adherence monitoring and support;
and (4) engagement of both peers and doctors in delivering psychoeducation.
Wilcoxon signed-rank test was used to compare urine morphine positive rates,
daily methadone dosage, and the number of days that clients successfully
accessed methadone before and during the intervention.
RESULTS:
During
the intervention, urine morphine positive rates reduced to 27 % from
49.3 % previously; p < 0.001. In response to client needs, methadone
dosages increased among 74 % of participants, remained unchanged among
12.0 %, and reduced among 13.4 % during the intervention. In
addition, the average daily methadone dose increased from 63.0 to 72.6 mg;
p < 0.001, while the average number of days that clients successfully
accessed methadone increased from 69.4 to 73.9 over a period of 12 weeks;
p < 0.001.
CONCLUSIONS:
Blended
treatment literacy and psychoeducation delivered by a combination of peers and
doctors was associated with reducedheroin use, improved treatment adherence, and higher
methadone doses among our sample of MMT clients.
- 1Yunnan Institute of Drug Abuse (YIDA), 300 Wujiadui, Xihuayuan, Xishan District, Kunming, Yunnan, China. zhangbo407@126.com.
- 2AIDS Care China, R 201, #17 Rongyuan, Jinjiang Residential Quarter, Bejing Road, Panlong District, Kunming, Yunnan, China. thomas@aidscarechina.org.
- 3AIDS Care China, R 201, #17 Rongyuan, Jinjiang Residential Quarter, Bejing Road, Panlong District, Kunming, Yunnan, China. zhyan@aidscarechina.org.
- 4International HIV/AIDS Alliance, 91-101 Davigdor Road, Hove, BN3 1RE, UK. gmburu@aidsalliance.org.
- 5Department of Health Research, Lancaster University, Lancaster, LA1 4YW, UK. gmburu@aidsalliance.org.
- 6Yunnan Institute of Drug Abuse (YIDA), 300 Wujiadui, Xihuayuan, Xishan District, Kunming, Yunnan, China. ylp412@126.com.
- Harm Reduct J. 2016 Feb 26;13(1):8. doi: 10.1186/s12954-016-0097-y.
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