A Clinic-Level Intervention May Promote Methadone Patients' Consistent Daily Adherence to Their Dosing Schedules.

BACKGROUND

Substandard practices in opioid treatment programs (OTPs) contribute to missed doses and treatment discontinuation. Training OTP staff to deliver trauma-informed methadone treatment can facilitate the adoption of patient-centered practices and improve patient methadone access and use. A clinic-level, multimodal intervention to promote patient-centered methadone care was pilot-tested in 2 Arizona OTP clinics.

METHODS

A single-arm, repeated measures pilot trial consisting of 1.5 months preintervention onboarding and 4 months intervention and data collection was conducted from September 2024 to March 2025. Consistent daily methadone adherence was the primary outcome. Data were collected from patients (n = 91) in surveys at baseline and monthly thereafter. Bayesian multilevel generalized linear mixed models estimated the changes in consistent daily dosing from baseline (preintervention) to study conclusion (postintervention).

RESULTS

Patients had a greater likelihood of consistent daily methadone adherence in the past 30 days at study endpoint compared to baseline (adjusted odds ratio 3.63 [95% credible interval 1.27-10.60]).

CONCLUSIONS

Findings from this exploratory study indicate the potential of this clinic-level intervention to support more consistent methadone use. Interpretive caution is advised as this is a single-arm design with study attrition, and limited follow-up period. Future studies will assess the effectiveness of this intervention in a large-scale, multisite randomized controlled trial.