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Effectiveness of a Psycho-Social Intervention Aimed at Reducing Attrition at Methadone Maintenance Treatment Clinics: A Propensity Score Matching Analysis

by Xiaoyan Fan 1,†, Xiao Zhang 1,2,†, Huifang Xu 3, Fan Yang 4, Joseph T.F. Lau 5,6, Chun Hao 1,7, Jinghua Li 1,7, Yuteng Zhao 3, Yuantao Hao 1,7 and Jing Gu 1,7,*
1
Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
2
Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang, China
3
Guangzhou Centre for Disease Prevention and Control, Guangzhou 510080, Guangdong, China
4
Institute for Global Health and Infectious Diseases, University of North Carolina, Project-China, Guangzhou 510080, Guangdong, China
5
Centre for Medical Anthropology and Behavioural Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
6
Centre for Health Behaviours Research, School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
7
Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
*
Author to whom correspondence should be addressed.
These two authors contributed equally to this paper.
Int. J. Environ. Res. Public Health 2019, 16(22), 4337; https://doi.org/10.3390/ijerph16224337
Received: 19 October 2019 / Revised: 30 October 2019 / Accepted: 4 November 2019 / Published: 7 November 2019
(This article belongs to the Section Health Care Sciences & Services)
Methadone maintenance treatment (MMT) is an important approach to address opioid dependence. However, MMT clinics usually report high attrition rates. Our previous randomized controlled trial demonstrated additional psycho-social services delivered by social workers could reduce attrition rates compared to MMT alone. This study aimed to evaluate the effectiveness of psycho-social service in a real-world context. A quasi-experimental design and propensity score matching was adopted. 359 clients were recruited from five MMT clinics in Guangzhou from July 2013 to April 2015. One 20-minute counseling session was offered to the control group after enrolment. The intervention group received six sessions of psycho-social services. The baseline characteristics were unbalanced between two arms in the original sample. After propensity score matching, 248 participants remained in the analysis. At month six, the intervention group had a lower attrition rate [intervention (39.5%) versus control (52.4%), P = 0.041], higher monthly income [monthly income of 1000 CNY or higher: intervention (55.9%) versus control (39.0%), P = 0.028)], higher detoxification intention score [full intention score: intervention (51.6%) versus control (32.5%), P = 0.012)], higher family support in MMT participation [intervention (77.9%) versus control (61.4%), P = 0.049)]. This study demonstrated that psycho-social services delivered by social workers can reduce MMT clients’ attrition and improve their well-being in real-world settings. View Full-Text
Keywords: methadone maintenance treatment; psycho-social intervention; attrition; propensity score matching; China methadone maintenance treatment; psycho-social intervention; attrition; propensity score matching; China
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Fan, X.; Zhang, X.; Xu, H.; Yang, F.; Lau, J.T.; Hao, C.; Li, J.; Zhao, Y.; Hao, Y.; Gu, J. Effectiveness of a Psycho-Social Intervention Aimed at Reducing Attrition at Methadone Maintenance Treatment Clinics: A Propensity Score Matching Analysis. Int. J. Environ. Res. Public Health 2019, 16, 4337.

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