Sociodemographic, clinical profile and the association with retention in treatment among patients receiving methadone treatment in Nairobi, Kenya

Abstract

Opioid use disorder is a common condition worldwide and is associated with a significant disease burden. There is limited research on factors that influence retention in methadone treatment in Kenya. This study aimed to assess patients’ sociodemographic and clinical profiles and the association of these factors with retention in methadone treatment at a clinic in Nairobi. This study used a cross-sectional descriptive design that involved retrospective abstraction of data from records of patients on methadone treatment. The data collected included: sociodemographic variables and clinical profiles of patients. The mean age was 32.9 (17-71) years, and 92.8% were males, of which 54% were actively retained in treatment. Ninety-nine percent used heroin at the start of treatment with predominant polysubstance use and early age of onset of substance use. Depressive symptoms were reported by 4.9%, anxiety symptoms by 3.2%, suicidal thoughts by 9.5%, violent behavior by 17.1%. Fifty-four patients were currently being treated for comorbid psychiatric illnesses. Physical abuse was reported by 51.7%, emotional abuse by 55.1%, and sexual abuse by 2.1%. Factors associated with retention in treatment were occupation, treatment duration, outpatient treatment attendance before starting methadone treatment, and continued use of opioids and cannabis during methadone treatment. Most participants receiving care at the methadone clinic have early onset of susbstance use and polysubstance use and, as such, are likely to present with numerous medical and psychiatric co-morbidities. Understanding the sociodemographic characteristics and treatment outcomes for clients on methadone treatment can guide opioid use prevention and treatment interventions both in schools and in the communities. Further studies are needed to identify and respond to barriers that clients on methadone treatment face that hinder the realization of positive treatment outcomes.