Article ; Online: Mobile methadone dispensing in Delhi, India: implementation research.
Bulletin of the World Health Organization
2021 Volume 99, Issue 6, Page(s) 422–428
Abstract: Objective: To assess the implementation of a mobile dispensing service to improve opioid users' access to methadone maintenance therapy.: Methods: In March 2019, we started mobile methadone dispensing in an urban underprivileged locality in Delhi, ... ...
| Abstract | Objective: To assess the implementation of a mobile dispensing service to improve opioid users' access to methadone maintenance therapy. Methods: In March 2019, we started mobile methadone dispensing in an urban underprivileged locality in Delhi, India. The doctor was available only at the main community drug treatment clinic for clinical services, while the nurse dispensed methadone from a converted ambulance. We involved patients in identifying community leaders for sensitization and in deciding the location and timings for dispensing. We conducted a retrospective chart review of the programme data collected during delivery of clinical services. We compared the numbers of patients registered for methadone therapy and their retention and adherence to therapy in the 12-month periods before and after implementation of the mobile service. Findings: The number of patients registered for therapy at the clinic increased from 167 in the year before implementation to 671 in the year after. A significantly higher proportion of patients were retained in therapy at 3, 6 and 9 months after enrolment; 9-month retention rates were 19% (32/167 patients) and 45% (44/97 patients) in the year before and after implementation, respectively. There was no significant difference in patients' adherence to therapy between the two periods. Challenges included providing suitable dispensing hours for patients in employment and concerns of local community near to the dispensing sites. Conclusion: It is feasible to dispense methadone by a mobile team in an urban setting, with better retention rates in therapy compared with dispensing through a stationary clinic. |
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| MeSH term(s) | Adult ; Analgesics, Opioid/therapeutic use ; Female ; Health Plan Implementation ; Humans ; India ; Male ; Methadone/therapeutic use ; Middle Aged ; Mobile Health Units/organization & administration ; Opiate Substitution Treatment ; Opioid-Related Disorders/drug therapy ; Opioid-Related Disorders/rehabilitation ; Program Evaluation ; Retrospective Studies ; Treatment Outcome |
| Chemical Substances | Analgesics, Opioid ; Methadone (UC6VBE7V1Z) |
| Language | English |
| Publishing date | 2021-03-19 |
| Publishing country | Switzerland |
| Document type | Journal Article |
| ZDB-ID | 80213-x |
| ISSN | 1564-0604 ; 0042-9686 ; 0366-4996 ; 0510-8659 |
| ISSN (online) | 1564-0604 |
| ISSN | 0042-9686 ; 0366-4996 ; 0510-8659 |
| DOI | 10.2471/BLT.20.251983 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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