The lived experiences and factors associated with defaulting among adults with opioids use disorders enrolled for methadone assisted therapy, Dodoma region Tanzania: a sequential qual-quant mixed study

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Date
2023
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Publisher
The University of Dodoma
Abstract
Background The defaulting of patients with opioid use disorders on methadone-assisted therapy is among the main challenges in the course of treatment worldwide. Several health, social, and economic impacts ranging from the individual to the community to the nation at large may result from treatment default. The lived experiences of clients under methadone-assisted therapy that may be associated with the defaulting of clients from methadone treatment in the context of central Tanzania remain unknown. Methods: The study aimed to explore the lived experiences of clients enrolled in methadone treatment that could be associated with the defaulting among adults with opioid use disorders at the Itega Dependency Treatment Centre in Dodoma, Tanzania. A mixed-methods study using a sequential QUAL approach was employed. The qualitative approach adopted a phenomenological design. A total of 18 study participants, including both defaulters and clients on regular medication, were recruited purposefully and interviewed using an in-depth interview guided by an interview guide to explore their lived experiences. The data was analyzed using thematic analysis. Qualitative results were used to inform the quantitative study. The quantitative component is based on a survey questionnaire and secondary data. Descriptive analysis and logistic regression were employed to explain the defaulting patterns and the factors associated with defaulting. Results: Five main themes emerged, including reasons and ways of enrolling in MAT, benefits of MAT to clients, side effects of methadone, communication between health care providers and clients, guidelines for receiving MAT at the clinic, and client suggestions on the overall run-up of the MAT clinic. The prevalence of defaulting was 46.8% (95% CI). Among the defaulters, most of them—35 (22.7%) defaulted only once, 21 (13.6%) defaulted twice, and 16 (10.4%) defaulted more than twice within 12 months. Factors associated with defaulting were education level, marital status, living arrangement and living satisfaction, number of substances used before MAT and continued substance use after MAT enrollment, history of VII comorbidities and co-occurring conditions, experience, and perception of MAT (95% CI, P > 0.005). Conclusion: The defaulting of patients with opioid use disorders from dependency treatment is common in the context of central Tanzania as its worldwide. Intrapersonal, interpersonal, and organizational factors are associated with defaulting.
Description
Dissertation (MSc in nursing mental health)
Keywords
Opioids Use Disorder, Methadone Assisted Therapy, Defaulting, Lived experiences
Citation
Temba, Neema J. (2023) The lived experiences and factors associated with defaulting among adults with opioids use disorders enrolled for methadone assisted therapy, Dodoma region Tanzania: a sequential qual-quant mixed study (Master’s Dissertation). The University of Dodoma, Dodoma