Incidence and predictors of non-adherence and reported barriers of adherence to medication assisted treatment with methadone among adults with opioid use disorder in Dodoma, Tanzania
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Date
2023
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
The University of Dodoma
Abstract
Background: Medication adherence is essential to achieve successful Medication Assisted Therapy (MAT) with methadone. An essential component of the treatment strategy is encouraging recovery in patients with Opioid Use Disorder. This can result in ongoing health gains and the enhancement of these patients' quality of life (QoL). Little information is available about the adherence status to the Methadone among MAT patients in the Dodoma region as well as other parts in Tanzania. Aim: This study aimed to assess the incidence, determine predictors of adherence, and explore reported barriers in MAT with methadone patients. Method: This study applied mixed research approach with combination of qualitative and quantitative research methods. A retrospective study design was used for the quantitative phase and a case study design was used for the qualitative phase. The study was conducted in one MAT clinic namely Itega drug dependence treatment Center. The sample size of the study was obtained using convenience and purposive sampling method. The Adherence of MAT with methadone was assessed by using three questions: 1) If they missed doses in the last 30 days; 2) whether they missed doses in the past 12 months and 3) If they have been jailed for more than 30 days consecutively since in past twelve months. Adherence was considered optimal if patients reported ‘no’ to three questions. Substance Use Characteristics and ASSIST to support adherence were also collected. Results: Of 227 patients, 43.61% reported non-adherence to their prescribed medications and 56.39% adhered to the prescribed methadone medication. The findings from the ASSIST tool indicated that, clients had strong urge to use Heroin, Morphine, Pain Medication (93.83%) which arouse concerns among their relatives. Also, the findings indicated that, the majority of the clients used the Heroin, Morphine, Pain Medication drugs in the past three months. Moreover, the study found that, the factors which contributed to adherence to MAT with methadone were those with significant association to incidence rate of adherence to MAT. Such factors were (p-value=0.0356), education level (p=0.0014), Occupation (p=0.0296), Marital status (p=0.0054), Taking methadone medication at appropriate time (p=0.0001), client having other diseases (p= 0.0042), Good provider client relationship (p= 0.0034) and the good provider to client relationship (p=0.0029). on the barriers of adherence to
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MAT with methadone, the findings of the study indicated that, hostile rapport and imbalanced treatment were among of the barriers to MAT related to health care providers. Further, lack of resources, negative attitudes and unpleasant behavioral challenges among OUDs clients were also found to affects the adherence of MAT with methadone. Conclusions: The adherence of MAT with methadone among OUDs clients is relatively low and a direct result of the aforementioned factors. To improve the adherence of MAT with methadone, health care providers and institutions urgently needs to address the barriers to MAT medications found in this study.
Description
Dissertation (MSc in public health)
Keywords
Incidence, Predictors, reported barriers, Medication Assisted Treatment with methadone
Citation
Omary, Rehema S. (2023) Incidence and predictors of non-adherence and reported barriers of adherence to medication assisted treatment with methadone among adults with opioid use disorder in Dodoma, Tanzania (Master’s Dissertation). The University of Dodoma, Dodoma.