The effectiveness of a transtheoretical model based on health education intervention on adherence to methadone maintenance treatment: a quasi-experimental study

Treatment adherence is one of the major challenges in methadone maintenance treatment (MMT). This study aimed to investigate the effect of educational intervention using a transtheoretical model (TTM) on adherence to MMT.

This quasi-experimental educational intervention study was conducted in Shiraz, Fars Province, Iran (2019), with 114 men aged 20 to 50 years. Participants were recruited using a two-stage cluster random sampling method. The mean age of the participants in the intervention group (n = 58) was 36.98 ± 7.76 years, while the control group (n = 56) had a mean age of 39.44 ± 6.54 years. The intervention group attended five educational sessions based on the Trans theoretical Model (TTM). Data analysis was conducted using SPSS with a significance level set at < 0.05. Statistical methods included Chi-square, paired t-test, independent t-test, and non-parametric tests when the data were not normally distributed.

The results indicated no significant difference between the two groups in terms of self-liberation, counter-conditioning, helping relationships, stimulus control, reinforcement management, temptation, confidence, and adherence to MMT before the intervention (p > 0.05). However, two months after the intervention, the intervention group showed a significant increase in each of the mentioned constructs (p < 0.05) except counterconditioning and MMT adherence.

The study's findings indicate that the educational program successfully improved participants' knowledge and skills regarding the processes of change, as well as their self-efficacy, which was assessed through two key constructs: temptation and confidence. However, the program did not succeed in enhancing participants' adherence to treatment. Policymakers should consider integrating structured educational programs based on the Theory of Planned Behavior (TPB) into existing Medication Management Therapy (MMT) services. This approach aims to enhance patients' understanding of their treatment processes and promote adherence. Furthermore, since the intervention positively impacted self-confidence and self-efficacy, it is advisable to develop policies that focus on educating patients to bolster their self-efficacy in resisting drug-related temptations. Future studies should also aim to include diverse populations, such as women and individuals from various age groups, to assess the generalizability of the findings beyond the male participants from specific regions.