A Clinic-Level Intervention May Promote Methadone Patients’ Consistent Daily Adherence to Their Dosing Schedules

BACKGROUND: Substandard practices in opioid treatment programs (OTPs) contribute to missed doses and treatment discontinuation. Training OTP staff to deliver trauma-informed methadone treatment can facilitate the adoption of patient-centered practices and improve patient methadone access and use. A clinic-level, multimodal intervention to promote patient-centered methadone care was pilot-tested in 2 Arizona OTP clinics. METHODS: A single-arm, repeated measures pilot trial consisting of 1.5 months preintervention onboarding and 4 months intervention and data collection was conducted from September 2024 to March 2025. Consistent daily methadone adherence was the primary outcome. Data were collected from patients (n = 91) in surveys at baseline and monthly thereafter. Bayesian multilevel generalized linear mixed models estimated the changes in consistent daily dosing from baseline (preintervention) to study conclusion (postintervention). RESULTS: Patients had a greater likelihood of consistent daily methadone adherence in the past 30 days at study endpoint compared to baseline (adjusted odds ratio 3.63 [95% credible interval 1.27-10.60]). CONCLUSIONS: Findings from this exploratory study indicate the potential of this clinic-level intervention to support more consistent methadone use. Interpretive caution is advised as this is a single-arm design with study attrition, and limited follow-up period. Future studies will assess the effectiveness of this intervention in a large-scale, multisite randomized controlled trial.