Impact of Community Drop-in Centers on Retention in Methadone Maintenance Treatment: A Mixed-method Study
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Abstract
Objective: 1) To evaluate the outcomes of the establishment of a community drop-in center for long-term methadone maintenance treatment (MMT) patients, focusing on treatment retention and opioid cessation, and 2) To assess patients’ perspectives regarding the quality of service following the establishment of the center. Methods: The study utilized a mixed-method research design. Quantitative study employed a retrospective pre-post quasi-experimental design. Data were collected from the medical records of all eligible MMT patients at Mae Wang Hospital and the drop-in center to compare clinical outcomes before and after the center’s establishment, spanning from 1 January 2023 to 31 December 2024. The qualitative study employed semi-structured interviews with 12 patients to gather perspectives on service quality. Results: A total of 156 MMT patients were included in the pre-post analysis. The majority were male (96.20%), with a mean age of 39.80±15.18 years, receiving a mean methadone dose of 19.96 ± 6.05 mg/day. The treatment retention rate during the study period before the establishment of the center was 38.46% (60/156 cases). The rate significantly increased after the center’s establishment to 69.87% (109/156 cases) (P < 0.001). Furthermore, the rate of opioid cessation also significantly increased from 27.56% to 42.31% (P < 0.001). Qualitative data from patients reflected that the drop-in center services reduced harms from narcotic uses, facilitated treatment access and supported reduction in substance use. Conclusion: The establishment of a drop-in center plays a significant role in increasing treatment retention and supporting opioid cessation. This is attributed to the service model mitigating access barriers and reducing the travel time burden for MMT patients. Consequently, the center serves as a key mechanism for addressing the challenge of retention in the treatment system and represents a deployable option to support harm reduction goals for opioid use.
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ผลการวิจัยและความคิดเห็นที่ปรากฏในบทความถือเป็นความคิดเห็นและอยู่ในความรับผิดชอบของผู้นิพนธ์ มิใช่ความเห็นหรือความรับผิดชอบของกองบรรณาธิการ หรือคณะเภสัชศาสตร์ มหาวิทยาลัยสงขลานครินทร์ ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากการพิมพ์ บทความที่ได้รับการเผยแพร่โดยวารสารเภสัชกรรมไทยถือเป็นสิทธิ์ของวารสารฯ
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