Effectiveness and Cost-Effectiveness of Drug Treatment Models for Patients without Comorbid Psychaitric Symptoms: A Case Study in Health Region 2, Thailand

Abstract

This action research examined the situation and operational models of community-based treatment (CBTx) for people who use drugs in Health Region 2. It aimed to identify success factors, barriers, and development needs, leading to the development of a context-appropriate and sustainable community-based treatment and rehabilitation model for green-group drug patients (CBTx-PLUS R2), and to recommend policy for scale-up. The research process included a review of national CBTx standards and Ministry of Public Health documents, followed by lesson-learned synthesis of community roles and service delivery systems. Qualitative data were collected through focus group discussions, and quantitative data through questionnaires and capacity assessment tools reflecting implementation status and partner readiness. Data were analyzed using descriptive and inferential statistics, including paired-sample t-tests to compare practitioners’ knowledge and competency before and after model development. The results showed that CBTx in Health Region 2 was strongly driven by community engagement and largely aligned with national guidelines. However, key limitations were identified, particularly insufficient workforce competency and the lack of an integrated information system, resulting in inconsistent case follow-up and continuity of care across areas. In response, CBTx-PLUS R2 was developed to strengthen community capacity for comprehensive care of green-group patients, reduce reliance on outpatient services, and improve continuity through individual case management supported by a shared information system via the Lomrak application. Training for community leaders and village health volunteers emphasized follow-up, relapse surveillance, and supportive communication. The model was feasible at both systemic and operational levels. Practitioners’ mean knowledge and competency scores increased significantly (p<0.05). Policy recommendations emphasize sustained resource support, workforce development, continuous capacity building, and an integrated information system linking health facilities and communities to enable broader implementation.