{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T02:40:44Z","timestamp":1793500844195,"version":"4.5.0"},"reference-count":48,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,2,27]],"date-time":"2023-02-27T00:00:00Z","timestamp":1677456000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug and Alcohol Review"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Decentralising methadone maintenance treatment to primary care improves patients' access to care and their drug and HIV treatment outcomes. However, primary care providers (PCP), especially those working in limited\u2010resource settings, are facing great challenges to provide quality methadone treatment. This study explores the challenges perceived by PCP providing methadone treatment at commune health centres in a mountainous region in Vietnam.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>We conducted in\u2010depth interviews with 26 PCP who worked as program managers, physicians, counsellors, pharmacists and medication dispensing staff at the methadone programs of eight commune health centres in Dien Bien, Vietnam, in November and December 2019. We used the health\u2010care system framework in developing the interview guides and in summarising data themes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Participants identified major challenges in providing methadone treatment in commune health centres at the individual, clinic and environmental levels. Individual\u2010level challenges included a lack of confidence and motivation in providing methadone treatment. Clinic\u2010level factors included inadequate human resources, lack of institutional support, insufficient technical support, lack of referral resources and additional support for patients. Environment\u2010level factors comprised a lack of reasonable policies on financial support for providers at commune health centres for providing methadone treatment, lack of regulations and mechanisms to ensure providers' safety in case of potential violence by patients and to share responsibility for overdose during treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion and Conclusion<\/jats:title><jats:p>PCP in Vietnam faced multi\u2010level challenges in providing quality methadone treatment. Supportive policies and additional resources are needed to ensure the effectiveness of the decentralisation program.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dar.13613","type":"journal-article","created":{"date-parts":[[2023,2,28]],"date-time":"2023-02-28T06:39:26Z","timestamp":1677566366000},"page":"803-814","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Challenges of methadone maintenance treatment decentralisation from Vietnamese primary care providers' perspectives"],"prefix":"10.1111","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1285-3791","authenticated-orcid":false,"given":"Diep Bich","family":"Nguyen","sequence":"first","affiliation":[{"name":"Center for Training and Research on Substance Abuse and HIV\/AIDS Hanoi Medical University  Hanoi Vietnam"},{"name":"Department of Epidemiology, Institute of Preventive Medicine and Public Health Hanoi Medical University  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3261-2098","authenticated-orcid":false,"given":"Trang Thu","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Center for Training and Research on Substance Abuse and HIV\/AIDS Hanoi Medical University  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunqing","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience &amp; Human Behavior University of California Los Angeles  Los Angeles USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thuy Thi Thanh","family":"Dinh","sequence":"additional","affiliation":[{"name":"Center for Training and Research on Substance Abuse and HIV\/AIDS Hanoi Medical University  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3370-4453","authenticated-orcid":false,"given":"Giang Minh","family":"Le","sequence":"additional","affiliation":[{"name":"Center for Training and Research on Substance Abuse and HIV\/AIDS Hanoi Medical University  Hanoi Vietnam"},{"name":"Department of Epidemiology, Institute of Preventive Medicine and Public Health Hanoi Medical University  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3402-142X","authenticated-orcid":false,"given":"Li","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience &amp; 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