Theme: Epidemiology & Public Health Research Year: 2024
Background: Among over 21,000 opioid agonist treatment (OAT) patients in Ukraine receiving either methadone or buprenorphine, 80% reach 6-month retention. The objective of this analysis was to assess correlates of OAT dropout in Ukraine given the on-going military conflict due to russia’s full-scale invasion of the country.
Methods: For this study, a national registry of OAT patients in Ukraine (N=21,387) was stratified into stable (n=8,256), non-stable (n=5,902), and dropout patients (n=7,229), and analyzed using multinomial logistic regression to compare the groups and identify demographic, drug and HIV treatment correlates of OAT program dropout.
Results: Mean age among stable, unstable and dropout patients was 38.3, 40.1, and 28.3 years respectively. Duration of injection before OAT ranged from 8.1 to 16.4 years with the longest duration among stable patients; time on OAT was 2.2, 2.6, and 4.3 years among stable, unstable, and dropout patients, respectively. Most patients were male (83.9-95.0%), on methadone (87.8-95.4%), received suboptimal OAT dosing (45.6-68.5%). Factors associated with being either unstable or dropout patient were younger age (aOR=1.28; 95% CI: 1.08-1.43, aOR=1.87; 95% CI: 1.23-2.49), male gender (aOR=0.39; 95% CI: 0.23-0.76, aOR=0.79; 95% CI: 0.24-0.98), suboptimal OAT dosing (aOR=2.14; 95% CI: 1.46-3.25, aOR=3.01; 95% CI: 1.42-4.09), coming for OAT daily (aOR=1.45; 95% CI: 1.16-2.76, aOR=1.18; 95% CI: 1.09-2.15), no access to psychosocial support at OAT site (aOR=0.76; 95% CI: 0.54-0.87, aOR=0.55; 95% CI: 0.38-0.63).
Conclusions: These results suggest that most of the barriers to retention in OAT are structural such as suboptimal dosing, daily dosing, no formal psychosocial support services on site rather that individual. Advocacy efforts at both national and regional levels could lead to program-level changes which will improve OAT retention among patients in Ukraine.
A Disclosure of Interest Statement
The authors have no conflict of interests to declare.