Using ADAPT-ITT framework to tailor evidence-based interventions for addressing methamphetamine use among methadone patients in Vietnam.
Le Minh Giang, Nguyen Thu Trang, Dinh Thanh Thuy, Hoa H Nguyen, Nguyen Bich Diep, Hoang Thi Hai Van, Thai Thanh Truc, Cathy J Reback, Michael Li, Do Van Dung, Steve Shoptaw
Author Information
Le Minh Giang: Centre for Training and Research on Substance use and HIV, Hanoi Medical University, Hanoi, Vietnam. ORCID
Nguyen Thu Trang: Centre for Training and Research on Substance use and HIV, Hanoi Medical University, Hanoi, Vietnam. ORCID
Dinh Thanh Thuy: Centre for Training and Research on Substance use and HIV, Hanoi Medical University, Hanoi, Vietnam.
Hoa H Nguyen: Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
Nguyen Bich Diep: Centre for Training and Research on Substance use and HIV, Hanoi Medical University, Hanoi, Vietnam. ORCID
Hoang Thi Hai Van: Global Health Department, Hanoi Medical University, Hanoi, Vietnam.
Thai Thanh Truc: Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
Cathy J Reback: Friends Research Institute, Friends Community Center, Center for HIV Identification, Prevention and Treatment Services, University of California, Los Angeles, California, USA.
Michael Li: Center for Behavioral and Addiction Medicine, Department of Family Medicine, University of California, Los Angeles, California, USA.
Do Van Dung: Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
Steve Shoptaw: Center for Behavioral and Addiction Medicine, Department of Family Medicine, University of California, Los Angeles, California, USA.
INTRODUCTION: Methamphetamine use threatens positive treatment outcomes in substance use and HIV, for people with opioid use disorders (POUD) in many countries. This paper describes the adaptation of four evidence-based interventions (EBI) (motivational interviewing, contingency management, Matrix group model and SMS text messaging) for treating methamphetamine use among POUD receiving methadone maintenance therapy in Vietnam. METHODS: Following the ADAPT-ITT (Assessment-Decision-Administration-Production-Topical experts-Training-Testing) framework, we conducted 16 focus group discussions with POUD (n = 25) and providers (n = 22) at four methadone clinics in two largest cities (Hanoi in the North, Ho Chi Minh City in the South) to assess patterns of methamphetamine use and to get feedback on proposed EBIs. The proposed EBIs were properly adapted and used to train providers in two of the four methadone clinics. The revised EBIs were tested over 12 weeks among 42 POUD on methadone who use methamphetamine. Post-intervention feedback served to fine-tune the revised EBIs. RESULTS: Insights about patterns of methamphetamine use suggested that EBIs should focus on different triggers to methamphetamine use among POUD receiving methadone treatment in the two cities. All EBIs should emphasise family-related topics to build a strong motivation for treatment. Participants suggested when, where and how each EBI should be delivered. Most participants were satisfied with the adapted EBIs. Limited human resources at methadone clinics might hinder implementation of the adapted EBIs. DISCUSSION AND CONCLUSIONS: We successfully completed the adaptation of EBIs for POUD who use methamphetamine on methadone in Vietnam. The pilot testing of the adapted EBIs demonstrated feasibility and acceptability. TRIAL REGISTRATION: NCT04706624. Registered 13 January 2021. https://clinicaltrials.gov/ct2/show/NCT04706624.
