Interventions for methamphetamine use among people on methadone maintenance treatment in Vietnam: a sequential multiple assignment randomized trial (STAR-OM)

作者：Le Minh Giang, Michael J. Li, Nguyen Thu Trang, Nguyễn Bích Diệp, Dao Thi Dieu Thuy, Đinh Thanh Thủy, Hán Đình Hòe, Hoàng Thị Hải Vân, Thai Thanh Truc, Hoa Hong Nguyen, Nguyen Ly Lai, Pham Thi Dan Linh, Vu Thi Tuong Vi, Cathy J. Reback, Arleen Leibowitz, Li Li, Chunqing Lin, Do Van Dung, Steven Shoptaw · 发表于：The Lancet Regional Health - Southeast Asia · 年份：2026 · DOI：10.1016/j.lansea.2026.100773 · 被引用次数：2 · 研究领域：Substance Abuse Treatment and Outcomes、HIV, Drug Use, Sexual Risk、Opioid Use Disorder Treatment

Background: Methamphetamine (MA) co-use with opioids has increased in Vietnam, hindering methadone maintenance therapy (MMT) through non-adherence and returning to opioid use. This study reports the primary outcomes of the "Screen, Treat and Retain people with opioid use disorders who use MA in methadone clinics" (STAR-OM) trial to integrate evidence-based behavioral interventions into MMT clinics and reduce MA co-use. Methods: STAR-OM was a sequential multiple assignment randomized trial (ClinicalTrials.gov Identifier: NCT04706624) with two 12-week intervention stages across 15 MMT clinics in Hanoi and Ho Chi Minh City, Vietnam. In the frontline intervention stage, 665 MMT patients who co-use MA were randomized to either a low-intensity frontline intervention of six weeks of contingency management (CM) followed by six weeks of group education, or a high-intensity frontline intervention of 12 weeks of CM. Participants who responded to treatment at the end of the frontline intervention stage-having 4 MA-negative urine drug screens (UDS) out of a possible 4 in Weeks 11 to 12-were reassigned to 12-weeks of theory-based text messaging for maintenance. Within each frontline intervention, those who did not have a treatment response were re-randomized to an adaptive intervention of either Matrix only or Matrix + CM for another 12 weeks. Segmented, two-level mixed effects logistic regression compared intervention effects on testing MA-negative over time. Findings: By Week 25, the low...