ID: HR19-119
Presenting author: Thomas Cai
Bangyuan Wang, Thomas Cai, Tingyan Luo, Marija Pantelic
Objective: Unnecessary threshold were often imposed as barriers for PWUD to access OST services, which often become barriers for clients to adhere to the treatment. This study examined the impact of the different thresholds to access take-home methadone on the compliance to MMT.
Methodology: MMT clients with good treatment compliance were recruited and given the option of taking their methadone doses home instead of having to come to the clinic every day. Clients are allowed to take 2-4 days of Methadone home. We compared the MMT compliance of two cohorts, each recruited with different criteria, one with a high threshold and the other with a lower threshold to be allowed to take methadone home.
Result: A total of 45 clients (33 male, 12 female) were allowed to take methadone home. 31 were recruited under high-threshold criteria and 14 with a lower threshold. The average number of days that each client took methadone per month increased from 27.81 to 29.95 in the high-threshold group and from 23.26 to 29. 81 in the low-threshold group. The urine morphine test positive rate decreased from 5.5% to 0.1% in the high-threshold group and from 12% to 0% in the low-threshold group. Among all the MMT clients, dropout rate decreased from 54.0% in 2013 to 40.3% in 2014 and urine test positive rate dropped from 21.4% in 2011 to 13.8% in 2014, in comparison with around 30% positive rate among MMT clients at average in Yunnan province.
Conclusion: Allowing clients to take methadone home improved clients’ adherence to methadone treatment and reduced heroin use. Changes in the recruiting criteria have no impact on the final adherence record. There may be additional spill-over benefits for MMT adherence among other clients in the clinic who are preparing to be qualified for take-home methadone.