Related Experiment Videos
Mobile methadone dispensing in Delhi, India: implementation research.
Ravindra Rao1, Deepak Yadav1, Roshan Bhad1
1National Drug Dependence Treatment Centre, Department of Psychiatry, 4th Floor, Teaching Block, All India Institute of Medical Sciences, New Delhi 110029, India.
Bulletin of the World Health Organization
|June 10, 2021
Summary
Mobile methadone dispensing improved access to treatment for opioid users in Delhi, India. The mobile service significantly increased patient retention in methadone maintenance therapy compared to the stationary clinic.
Area of Science:
- Public Health
- Addiction Medicine
- Mobile Health
Background:
- Opioid use disorder remains a significant public health challenge globally.
- Methadone maintenance therapy (MMT) is a cornerstone treatment for opioid use disorder.
- Access to MMT can be limited in urban, underprivileged settings due to logistical barriers.
Purpose of the Study:
- To evaluate the implementation of a mobile methadone dispensing service.
- To assess the impact of the mobile service on patient access to MMT.
- To compare patient retention and adherence rates before and after mobile service implementation.
Main Methods:
- A mobile methadone dispensing service was initiated in an urban underprivileged area in Delhi, India.
- A converted ambulance served as the mobile dispensing unit, with a nurse dispensing and a doctor available at a central clinic.
- Patient data (registration, retention, adherence) were retrospectively reviewed for 12 months pre- and post-implementation.
Main Results:
- Patient registration for MMT increased from 167 to 671 annually after mobile service implementation.
- A significantly higher proportion of patients were retained in therapy at 3, 6, and 9 months.
- Nine-month retention rates improved from 19% to 45%; adherence rates showed no significant difference.
Conclusions:
- Mobile methadone dispensing is a feasible strategy in urban settings.
- The mobile service demonstrably improved patient retention in methadone maintenance therapy.
- Challenges included optimizing dispensing hours and addressing community concerns.