Patient Trust in Healthcare Providers among People on Methadone Maintenance Treatment Using Methamphetamine in...

Patient trust in healthcare providers (PTP) is critical for improving treatment adherence and outcomes in substance use disorders. As concurrent opioid and methamphetamine use increasingly complicates methadone maintenance treatment (MMT), understanding PTP in this population is essential. This study aimed to examine factors associated with PTP among people on MMT using methamphetamine in Vietnam.

We analyzed baseline data from a randomized clinical trial (NCT04706624) evaluating adaptive, evidence-based interventions to reduce methamphetamine use among MMT patients in Vietnam. The analysis included 412 MMT patients using methamphetamine who completed the 10-item Trust in Physicians Scale. Guided by the Social Ecological Framework, we examined individual, interpersonal, health-system, and socio-cultural factors associated with PTP using linear mixed-effects regression models.

The mean PTP score was 36.6 out of 50. Female patients (β = -1.33; p = 0.012) and those with higher education (β = -1.17; p = 0.002) reported lower PTP, while provider-patient interaction showed no significant association. PTP was lower among patients treated in clinics located in a major southern city compared to those in a major northern city (β = -2.49; p < 0.001) and in clinics established after the national MMT scale-up compared to earlier-established clinics (β = -1.21; p = 0.009). Experienced MMT-related stigma from healthcare providers (β = -0.45, p < 0.001) was linked to lower PTP, while a higher social support score (β = 0.02, p = 0.036) was linked to greater PTP.

Findings underscore the need to reduce provider stigma, ensure consistent care quality across clinics, and strengthen rapport with female and educated patients. Leveraging social support and the stability of long-established clinics may foster greater PTP.