Retention and its predictors among methadone maintenance treatment clients in China: A six-year cohort study
Retention and its predictors among methadone maintenance treatment clients in China: A six-year cohort study
复制标题
DOI：
10.1016/j.drugalcdep.2014.09.776
复制
发表时间：
2014-12-01
影响因子：
4.2
通讯作者：
Li, Jianhua
中科院分区：
文献类型：
--
作者：
Cao, Xiaobin;Wu, Zunyou;Li, Jianhua
背景资料：目的：探讨影响我国首批美沙酮维持治疗（MMT）门诊吸毒者保留率的相关因素。方法：选取2004年在我国首批8家MMT门诊接受美沙酮维持治疗的1511名吸毒者，进行为期6年的随访。通过美沙酮剂量、诊所位置和随访时间来计算和比较六年的保留率。结果：6年以上的总留存率为35.7%。最高的脱落发生在治疗的前12个月内。美沙酮低剂量组（60 mg/d）6年的保留率分别为20.8%、34.8%和53.2%（p < 0.001）。6年留存率最高的为43.8%，最低的为17.7%（P < 0.001）。考克斯比例风险模型的结果表明，美沙酮日剂量>30 mg（p < 0.001）、有亲属接受MMT（p = 0.027）和尿吗啡阳性结果>10%（p < 0.001）的客户更有可能在6年期间留在MMT。它还发现，药物注射（p = 0.005）和针头共享（p < 0.0001）显着相关更好retention.Conclusions：卫生工作者应调整个人的美沙酮剂量作为一种方法，以防止早期终止治疗。阿片类药物成瘾严重程度对MMT患者长期保持的影响尚需进一步研究。在MMT登记时仔细评估吸毒者可能有助于为客户提供额外的护理。(C)由Elsevier爱尔兰Ltd.出版
Background: To investigate factors associated with retention among the first cohort of drug users attending methadone maintenance treatment (MMT) clinics in China.Methods: A six-year cohort of 1511 drug users was enrolled in the first 8 MMT clinics in China in 2004 and followed between March, 2004 and December, 2010. Six-year retention rates were calculated and compared by methadone dosage, clinic location, and length of follow-up. Factors associated with retention were evaluated using Cox proportional hazard regression models.Results: The overall retention rate over 6-year was 35.7%. Highest drop-out occurred within the first 12 months of treatment. The retention rates for the 6-year by low (60 mg/day) methadone dosage groups were 20.8%, 34.8% and 53.2%, respectively (p < 0.001). The highest 6-year retention rate among eight clinics was 43.8%, while the lowest one was 17.7% (p < 0.001). The results from Cox proportional hazard models indicate that clients having >30 mg daily methadone dosage (p < 0.001), having relatives receiving MMT (p = 0.027), and having >10% urine morphine positive result (p < 0.001) were more likely to be retained in MMT over the six-year period. It has also found that drug injection (p = 0.005) and needle sharing (p < 0.0001) were significantly associated with better retention.Conclusions: Health workers should adjust individuals' methadone dosages as a method to prevent early treatment termination. Further studies are needed to explore the impact of severity of opiate addiction on long-term retention of MMT clients. Careful assessment of drug users upon MMT enrollment may be helpful for providing additional care to clients. (C) 2014 Published by Elsevier Ireland Ltd.