Methadone maintenance treatment participant retention and behavioural effectiveness in China: a systematic review and meta-analysis.
<h4>Background</h4>Methadone maintenance treatment (MMT) has been scaled up by the Chinese government alongside persistent compulsory drug user detention, but the extent to which detention interferes with MMT is unknown. The study systematically reviews Chinese MMT retention rates, reaso...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2013-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0068906 |
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| author | Lei Zhang Eric P F Chow Xun Zhuang Yanxian Liang Yafei Wang Caiyun Tang Li Ling Joseph D Tucker David P Wilson |
| author_facet | Lei Zhang Eric P F Chow Xun Zhuang Yanxian Liang Yafei Wang Caiyun Tang Li Ling Joseph D Tucker David P Wilson |
| author_sort | Lei Zhang |
| collection | DOAJ |
| description | <h4>Background</h4>Methadone maintenance treatment (MMT) has been scaled up by the Chinese government alongside persistent compulsory drug user detention, but the extent to which detention interferes with MMT is unknown. The study systematically reviews Chinese MMT retention rates, reasons for drop out, and behavioural changes.<h4>Method</h4>Chinese and English databases of literature are searched for studies reporting retention rates, drug use and sexual behaviours among MMT participants in China between 2004 and 2013. The estimates are summarized through a systematic review and meta-analysis.<h4>Results</h4>A total of 74 studies representing 43,263 individuals are included in this analysis. About a third of MMT participants drop out during the first three months of treatment (retention rate 69.0% (95% CI 57.7-78.4%)). Police arrest and detention in compulsory rehabilitation was the most common cause of drop out, accounting for 22.2% of all those not retained. Among retained participants, changing unsafe drug use behaviours was more effective than changing unsafe sexual behaviours. At 12 months following MMT initiation, 24.6% (15.7-33.5%) of MMT participants had a positive urine test, 9.3% (4.7-17.8%) injected drugs and only 1.1% (0.4-3.0%) sold sex for drugs. These correspond to 0.002 (<0.001-0.011), 0.045 (0.004-0.114) and 0.209 (0.076-0.580) times lower odds than baseline. However, MMT participants did not have substantial changes in condom use rates.<h4>Conclusion</h4>MMT is effective in drug users in China but participant retention is poor, substantially related to compulsory detention. Reforming the compulsory drug user detention system may improve MMT retention and effectiveness. |
| format | Article |
| id | doaj-art-876fd7d149f24544a065b0171b2e6242 |
| institution | OA Journals |
| issn | 1932-6203 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-876fd7d149f24544a065b0171b2e62422025-08-20T02:36:35ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-0187e6890610.1371/journal.pone.0068906Methadone maintenance treatment participant retention and behavioural effectiveness in China: a systematic review and meta-analysis.Lei ZhangEric P F ChowXun ZhuangYanxian LiangYafei WangCaiyun TangLi LingJoseph D TuckerDavid P Wilson<h4>Background</h4>Methadone maintenance treatment (MMT) has been scaled up by the Chinese government alongside persistent compulsory drug user detention, but the extent to which detention interferes with MMT is unknown. The study systematically reviews Chinese MMT retention rates, reasons for drop out, and behavioural changes.<h4>Method</h4>Chinese and English databases of literature are searched for studies reporting retention rates, drug use and sexual behaviours among MMT participants in China between 2004 and 2013. The estimates are summarized through a systematic review and meta-analysis.<h4>Results</h4>A total of 74 studies representing 43,263 individuals are included in this analysis. About a third of MMT participants drop out during the first three months of treatment (retention rate 69.0% (95% CI 57.7-78.4%)). Police arrest and detention in compulsory rehabilitation was the most common cause of drop out, accounting for 22.2% of all those not retained. Among retained participants, changing unsafe drug use behaviours was more effective than changing unsafe sexual behaviours. At 12 months following MMT initiation, 24.6% (15.7-33.5%) of MMT participants had a positive urine test, 9.3% (4.7-17.8%) injected drugs and only 1.1% (0.4-3.0%) sold sex for drugs. These correspond to 0.002 (<0.001-0.011), 0.045 (0.004-0.114) and 0.209 (0.076-0.580) times lower odds than baseline. However, MMT participants did not have substantial changes in condom use rates.<h4>Conclusion</h4>MMT is effective in drug users in China but participant retention is poor, substantially related to compulsory detention. Reforming the compulsory drug user detention system may improve MMT retention and effectiveness.https://doi.org/10.1371/journal.pone.0068906 |
| spellingShingle | Lei Zhang Eric P F Chow Xun Zhuang Yanxian Liang Yafei Wang Caiyun Tang Li Ling Joseph D Tucker David P Wilson Methadone maintenance treatment participant retention and behavioural effectiveness in China: a systematic review and meta-analysis. PLoS ONE |
| title | Methadone maintenance treatment participant retention and behavioural effectiveness in China: a systematic review and meta-analysis. |
| title_full | Methadone maintenance treatment participant retention and behavioural effectiveness in China: a systematic review and meta-analysis. |
| title_fullStr | Methadone maintenance treatment participant retention and behavioural effectiveness in China: a systematic review and meta-analysis. |
| title_full_unstemmed | Methadone maintenance treatment participant retention and behavioural effectiveness in China: a systematic review and meta-analysis. |
| title_short | Methadone maintenance treatment participant retention and behavioural effectiveness in China: a systematic review and meta-analysis. |
| title_sort | methadone maintenance treatment participant retention and behavioural effectiveness in china a systematic review and meta analysis |
| url | https://doi.org/10.1371/journal.pone.0068906 |
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