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Heroin Addiction and Related Clinical Problems: 2024, 26, 26

A community-based tele medication-assisted treatment (TMAT) for delivery of methadone maintenance treatment (MMT) during the COVID-19 pandemic in India: A single-arm, prospective feasibility study

Roshan Bhad, Deepak MB, Vinit Patel, Jaswant Jangra, Ravindra Rao, and Pooja Shakya

Digital Object Identifier:
https://doi.org/10.62401/2531-4122-2024-26

Summary: Background: Opioid agonist treatment (OAT) is the most effective evidence-based strategy for management of opioid use disorder (OUD). In India, OAT is provided in government hospitals and through community-based OAT clinics. The COVID-19 pandemic and nationwide lockdown have adversely impacted OAT service delivery in the country. The community-based OAT clinic provides low threshold, free-of-cost services, responded to the COVID-19 pandemic challenge, and continued OAT throughout the pandemic. Substantial changes in its operations were made, including implementing OAT delivery using telemedicine technology and a pre-existing clinical workflow automation-based digital platform. Aims: We aimed to assess the feasibility of community-based Tele Medication Assisted Treatment (TMAT) for delivery of Methadone Maintenance Treatment (MMT) at the mobile methadone dispensing unit. Methods: 110 opioid use disorder participants receiving MMT at the mobile methadone dispensing unit participated in TMAT during the COVID-19 pandemic. Data regarding sociodemographic details, clinical profile, perceived satisfaction using client satisfaction questionnaire (CSQ-8), and rates of 3 months retention pre and post-implementation of TMAT services were collected. Results: The retention rate increased from 53% before TMAT to 68% after the implementation of TMAT. The mean retention duration increased significantly after TMAT services (p<0.01). Conclusions: Community-based TMAT for delivery of MMT is feasible, convenient, and cost-saving. The effectiveness of the model face-to-face consultation needs to be studied in a larger sample and a longer observation period.

Keywords: COVID-19 pandemic; opioid agonist treatment; low threshold treatment; community-based treatment; teleconsultation