1. Assessment of a psychiatric intervention at community level for people who inject drugs in a low-middle income country: the DRIVE-Mind cohort study in Hai Phong, Viet Nam
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Laurent Michel, Sao Mai Le, Giang Hoang Thi, Philippe Trouiller, Huong Duong Thi, Oanh Khuat Thi Hai, Khue Pham Minh, Roselyne Vallo, Delphine Rapoud, Catherine Quillet, Thuy Linh Nguyen, Quang Duc Nguyen, Tuyet Thanh NhamThi, Jonathan Feelemyer, Vinh Vu Hai, Jean-Pierre Moles, Hong Quang Doan, Didier Laureillard, Don C. Des Jarlais, Nicolas Nagot, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Hai Phong University of Medicine and Pharmacy [Hai Phong, Vietnam], Supporting Community Development Initiatives [Hanoï, Vietnam], Pathogenesis and Control of Chronic and Emerging Infections (PCCEI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université des Antilles (UA)-Etablissement français du don du sang [Montpellier], New York University [New York] (NYU), NYU System (NYU), Viet Tiep Hospital [Hai Phong, Vietnam], Hôpital Universitaire Carémeau [Nîmes] (CHU Nîmes), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), This work was supported by grants from NIDA (US) (#DA041978) and ANRS (France) (#13353)., DRIVE Study Team, and BONIZEC, Sandrine
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[SDV]Life Sciences [q-bio] ,VND, Vietnamese dong ,Internal Medicine ,MINI, MINI international neuropsychiatric interview ,EQ5D5L, 5 levels/5 dimensions EuroQol instrument ,ComputingMilieux_MISCELLANEOUS ,CBO, community-based organization ,MMT, methadone maintenance treatment ,Health Policy ,ANRS, French Agency for Research on AIDS and Viral Hepatitis ,PWID, people who inject drugs ,Public Health, Environmental and Occupational Health ,Obstetrics and Gynecology ,CGI, clinical global impression scale ,SCDI, Supporting Community Development Initiatives ,DRIVE, Drug-Related Infections in ViEtnam ,LMICs, low-middle income countries ,PHQ, patient health questionnaire ,RDS, respondent driven sampling ,HIV, human immunodeficiency virus ,NIDA, National Institute on Drug Abuse ,[SDV] Life Sciences [q-bio] ,Psychiatry and Mental health ,Infectious Diseases ,Pediatrics, Perinatology and Child Health ,Geriatrics and Gerontology ,Public aspects of medicine ,RA1-1270 ,Research Paper - Abstract
Summary: Background: Access to psychiatric care for people who inject drugs (PWID) is limited/absent and stigmatized in most low-middle-income countries (LMICs). Innovative interventions are needed. We aimed to describe and assess the impact of a community-based psychiatric intervention among PWID in Hai Phong, Vietnam Methods: In a cohort study with one year psychiatric follow-up, PWID diagnosed with a psychotic disorder, a major depressive episode, or suicide risk, were recruited from the wider Drug-Related Infections in ViEtnam (DRIVE) project in the city of Hai Phong. The community-based psychiatric intervention included specialized follow-up (free consultations with psychiatrists, free medication, referral to mental health department for hospitalization when necessary) and support from community-based organisations (case management, harm reduction, administrative support, linkage to HIV care, methadone maintenance treatment and mental health support). The main outcome was reduction/remission of symptoms. Access to and retention in psychiatric care, quality-of-life and stigmatization were also measured pre and post-intervention. Findings: Among the 1212 participants screened from March to May 2019, 271 met the inclusion criteria, 233 (86.3%) accepted the intervention and 170 completed the follow-up (72.9%). At inclusion, 80.6% were diagnosed with current depression, 44.7% with psychotic disorder and 42.4% with suicide risk. After a one-year follow-up, these proportions dropped to 15.9%, 21.8%, and 22.9% respectively. Quality-of-life and perceived stigma related to mental health were also significantly improved, while drug use decreased only marginally. Interpretation: Community-based psychiatric interventions are both feasible and efficient in the Vietnamese context. Similar interventions should be implemented and evaluated in other, different LMICs. Funding: This work was supported by grants from NIDA (US) (#DA041978) and ANRS (France) (#13353). The funding agencies had no role in designing the research, data analyses, or preparation of the report.
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- 2021
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