Predictive factors for treatment retention in methadone programs in Indonesia
Predictive factors for treatment retention in methadone programs in Indonesia
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DOI：
10.1016/j.jsat.2011.07.009
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发表时间：
2012-04-01
影响因子：
3.9
通讯作者：
Ali, Robert
中科院分区：
文献类型：
--
作者：
Sarasvita, Riza;Tonkin, Anne;Ali, Robert
本文介绍了在印度尼西亚进行的一项为期6个月的美沙酮维持治疗（MMT）前瞻性队列研究的结果。该研究旨在调查印度尼西亚MMT保留的预测变量。治疗持续时间（以天为单位）是研究的主要结果。在这项研究中，程序、客户、社交网络和可访问性因素作为留存率的潜在预测因素进行了调查。该研究分析了预测治疗保留的每个因素的相对权重。样本包括来自三个参与诊所的178名客户：雅加达的Rumah Sakit Ketergantungan Obat和Tanjung Priok以及巴厘岛的Sanglah。3个月和6个月的留存率分别为74.2%和61.3%。这些比率与以前在发达国家进行的研究相当。一项使用Cox PH回归稳健估计的生存分析发现，保留的最强预测因子是美沙酮剂量，其次是带回家剂量和提供这种治疗的诊所经验之间的相互作用。其他重要的预测变量包括年龄，感知诊所的可及性和客户对项目的信念。该研究得出结论，MMT不能仅仅依靠药理学来保留，而且还应该促进知情获得带回家的剂量。(C) 2012爱思唯尔公司版权所有。
This article presents the results of a 6-month prospective cohort study of methadone maintenance treatment (MMT) in Indonesia. The study aimed to investigate the predictor variables of retention in MMT in Indonesia. The duration of treatment (in days) was the main outcome of the study. For the study, program, client, social network, and accessibility factors were investigated as potential predictors of retention. The study analyzed the relative weight of each factor in predicting treatment retention. The sample consisted of 178 clients drawn from three participating clinics: Rumah Sakit Ketergantungan Obat and Tanjung Priok in Jakarta and Sanglah in Bali. The 3- and 6-month retention rates were 74.2% and 61.3%, respectively. These rates are comparable with previous studies conducted in developed countries. A survival analysis using a robust estimation for the Cox PH regression found that the strongest predictors of retention were methadone dose followed by an interaction between take-home dose and the experience of the clinic providing this treatment. Other significant predictor variables included age, perceived clinic accessibility, and client's belief in the program. The study concludes that MMT cannot solely rely on the pharmacology for retention but should also promote informed access to take-home doses. (C) 2012 Elsevier Inc. All rights reserved.