RCT in Ukraine shows health care benefits of primary care methadone

In a study, “Integrating Methadone Services Into Primary Care in Ukraine: Two‐Year Outcomes From a Randomized Trial,” researchers have found that Integrating methadone treatment into primary care settings improves adherence to health care without compromising methadone retention and treatment quality. The study, published in the Annals of Internal Medicine this month, was funded by the U.S. National Institute on Drug Abuse. The researchers stated in background information that access to methadone is limited and low‐ and middle‐income countries like Ukraine. This can be improved by providing access via primary care, but the main barrier is “provider discomfort,” the researchs noted. They wanted to compare health care use among people with opioid use disorder (OUD) receiving methadone in specialty clinics versus primary care centers in Ukraine. The study was conducted in 13 cities in Ukraine, with a total of 1,459 adults, 950 receiving methadone through primary care, 509 through specialty clinics. In the primary care intervention group, methadone delivery was assited by “telementoring.” The primary outcome was quality health indicators at 24 months. The study found that participants in primary care settings achieved higher composite health quality scores than those in specialty clinics, with a mean difference of 9.1 percentage points. Methadone retention among new patients at 24 months was 67.2% in primary care versus 64.7% in specialty clinics. The main limitation was that quality health indicators reflect health care use rather than health outcomes.