Evidence map›Paper›PMID 41359964›Full record

Trial reportAnnals of internal medicine2026

Integrating Methadone Services Into Primary Care in Ukraine: Two-Year Outcomes From a Randomized Trial.

Eteri Machavariani, Denise Esserman, Kostyantyn Dumchev, Myroslava Filippovych, Iryna Pykalo, Roman Ivasiy, Lynn M Madden, Daniel J Bromberg, Marwan Haddad, Olga Morozova and 4 more

Registry-linked trialAbstract readRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Annals of internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04927091 (Integrating Addiction Treatment and HIV Services Into Primary Care Clinics in Ukraine), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04927091 nacompletednot on this map

Integrating Addiction Treatment and HIV Services Into Primary Care Clinics in Ukraine

TypeinterventionalSponsorYale UniversityRan2017 to 2024Enrolled1,458ConditionsHiv, Opioid-use DisorderArmsIntegration of HIV and PWID services
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Eteri MachavarianiYale School of Medicine, Department of Medicine, Section of Infectious Diseases, and Center for Interdisciplinary Research on AIDS, Yale University, New Haven, Connecticut, and New York University School of Global Public Health, New York University, New York, New York (E.M.).ORCID 0000-0001-8138-2300
Denise EssermanCenter for Interdisciplinary Research on AIDS and Yale School of Public Health, Yale University, New Haven, Connecticut (D.E.).
Kostyantyn DumchevUkrainian Institute on Public Health Policy, Kyiv, Ukraine (K.D., M.F., S.D.).
Myroslava FilippovychUkrainian Institute on Public Health Policy, Kyiv, Ukraine (K.D., M.F., S.D.).ORCID 0000-0002-6377-5271
Iryna PykaloEuropean Institute of Public Health Policy, Kyiv, Ukraine (I.P.).ORCID 0000-0001-9290-8902
Roman IvasiyYale School of Medicine, Department of Medicine, Section of Infectious Diseases, and Center for Interdisciplinary Research on AIDS, Yale University, New Haven, Connecticut (R.I.).
Lynn M MaddenYale School of Medicine, Department of Medicine, Section of Infectious Diseases, Yale University, and APT Foundation, New Haven, Connecticut (L.M.M.).ORCID 0000-0002-9981-3938
Daniel J BrombergYale School of Medicine, Department of Medicine, Section of Infectious Diseases, Center for Interdisciplinary Research on AIDS, and Yale School of Public Health, Yale University, New Haven, Connecticut (D.J.B.).
Marwan HaddadCenter for Key Populations, Community Health Center, Middletown, Connecticut (M.H.).ORCID 0000-0002-6187-6407
Olga MorozovaDepartment of Public Health Sciences, University of Chicago, Chicago, Illinois (O.M.).ORCID 0000-0001-7606-8413
David OliverosYale School of Medicine, Department of Medicine, Section of Infectious Diseases, Yale University, New Haven, Connecticut (D.O., B.A.).ORCID 0009-0008-2054-6605
Bachar AhmadYale School of Medicine, Department of Medicine, Section of Infectious Diseases, Yale University, New Haven, Connecticut (D.O., B.A.).ORCID 0000-0003-3536-1052
Sergii DvoriakUkrainian Institute on Public Health Policy, Kyiv, Ukraine (K.D., M.F., S.D.).ORCID 0000-0002-0032-5417
Frederick L AlticeYale School of Medicine, Department of Medicine, Section of Infectious Diseases, Center for Interdisciplinary Research on AIDS, and Yale School of Public Health, Yale University, and APT Foundation, New Haven, Connecticut (F.L.A.).ORCID 0000-0002-7860-693X

Funding

Expanding Medication Assisted Therapy in Ukraine (ExMAT)R01DA033679 · NIDA · YALE UNIVERSITY · PI ALTICE, FREDERICK LEWIS · 2012 to 2021
$6.4M
Integrating Addiction Treatment and HIV Services into Primary Care Clinics in UkraineR01DA043125 · NIDA · YALE UNIVERSITY · PI ALTICE, FREDERICK LEWIS · 2016 to 2021
$4.4M
NIDA NIH HHS R01 DA033679NIDA NIH HHS R01 DA043125
6 · The paper itself

Abstract

backgroundOpioid use disorder (OUD) drives high morbidity and mortality, but access to opioid agonist therapy (OAT) is limited in low- and middle-income countries. Integrating OAT into primary care may expand access and improve comorbidity management, although provider discomfort remains a barrier.

objectiveTo compare health care use among persons with OUD receiving methadone in specialty clinics versus primary care centers in Ukraine (January 2018 to December 2023).

designTwo-group randomized controlled trial with 2:1 allocation to intervention and control. (ClinicalTrials.gov: NCT04927091).

settingThirteen cities in Ukraine: Cherkasy, Dnipro, Kramatorsk, Kropyvnytskyi, Kryvyi Rih, Kyiv, Lviv, Mariupol, Mykolaiv, Odesa, Rivne, Sloviansk, and Zhytomyr.

participantsA total of 1459 adults with OUD (950 intervention, 509 control) initiating or receiving methadone.

interventionMethadone delivered in primary care aided with telementoring, an Extension for Community Healthcare Outcomes-like model that is adapted to the Ukraine context, versus standard specialty clinic care. MEASUREMENTS: Primary outcome: difference in composite quality health indicator (QHI) scores between groups at 24 months, representing access to 17 guideline-concordant services (9 primary care and 8 specialty care) received, assessed through surveys and ranging from 0 to 100. Secondary outcomes: domain-specific QHI scores and methadone treatment indicators.

resultsParticipants in primary care settings achieved higher composite QHI scores than those in specialty clinics, with a mean difference of 9.1 percentage points (95% CI, 6.9 to 11.2 percentage points) at 24 months. Results were similar for primary care QHI (12.3 percentage points [CI, 9.0 to 15.6 percentage points]) and specialty care QHI (5.2 percentage points [CI, 0.2 to 10.3 percentage points]). Methadone retention among new patients at 24 months was 67.2% in primary care versus 64.7% in specialty clinics. LIMITATIONS: Quality health indicators reflect health care use rather than health outcomes. Quality health indicators were equally weighted despite differing clinical significance.

conclusionIntegrating methadone treatment into primary care settings improves adherence to guideline-concordant health care without compromising methadone retention and treatment quality. PRIMARY FUNDING SOURCE: National Institute on Drug Abuse.

Indexed as

MethadoneOpiate Substitution TreatmentOpioid-Related DisordersPrimary Health CareAdultFemaleHumansMaleMiddle AgedUkraineMethadone

Identifiers

PMID41359964
PMCPMC13048832

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.