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
Authors
Journal Title
Journal ISSN
Volume Title
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