Factors associated with one year retention to methadone maintenance treatment program among patients with heroin dependence in China.
Factors associated with one year retention to methadone maintenance treatment program among patients with heroin dependence in China.
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DOI：
10.1186/1747-597x-9-11
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发表时间：
2014-02-24
期刊：
影响因子：
--
通讯作者：
Zhao M
中科院分区：
文献类型：
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作者：
Jiang H;Han Y;Du J;Wu F;Zhang R;Zhang H;Wang J;Zhou Z;Hser YI;Zhao M
本研究的目的是在中国进行一项为期1年的随访队列研究，评估美沙酮维持治疗（MMT）门诊脱落的相关风险因素。对上海3家、昆明2家5个门诊的320例海洛因依赖者进行为期1年的MMT依从性分析。所有参与者均来自中美合作项目“关于提高中国美沙酮维持治疗依从性和有效性的研究”部分。我们的数据分析包括患者在6个月的临床研究中的出勤率和6个月后的数据。成瘾严重程度指数（ASI）是一种涵盖社会人口学特征和药物使用史的半结构式问卷。从MMT诊所登记系统中提取招募后1年的门诊就诊率和每日剂量。采用考克斯比例风险模型探讨脱落的危险因素，脱落定义为连续7天未使用美沙酮。治疗1年后，86例患者仍在接受MMT治疗，无脱落（上海87%，昆明13%）。在整个1年期间，留在项目中的中位天数为84天（上海和昆明分别为317天和22天）。与保留相关的因素包括年龄（HR = 0.98，95% CI：0.96 - 0.99，P = 0.0062）和ASI酒精评分（HR = 5.72，95% C.I.：1.49 - 21.92，P = 0.0109）。新招募的海洛因依赖患者的一年保留与基线时的年龄和ASI酒精评分相关。对于年轻且有更严重酒精问题的患者，依从性较差。
The aim of this study was to evaluate the risk factors associated with dropout from Methadone Maintenance Treatment (MMT) clinics within a 1 year follow-up cohort study in China. A data analysis is to explore the adherence of MMT during one year from three hundred and twenty patients with heroin dependence at five clinics (3 in Shanghai, 2 in Kunming) in China. All participants were from the part of China-United States cooperation project entitled “Research about improving the compliance and efficacy of methadone maintenance treatment in China”. Our data analysis includes the patients’ attendance in the 6 months clinical study and the data in another 6 months afterward. The data of patients at baseline were collected with the Addiction Severity Index (ASI) which is a semi-structured questionnaire covering socio-demographic characteristics and drug use history. The one year attendance after recruitment at the clinics and daily dose were abstracted from the MMT clinic register system. The Cox proportional hazards model were used to explore the risk factor of dropout, defined as seven consecutive days without methadone. By the end of 1 year of treatment 86 patients still remained in MMT without dropout (87% in Shanghai and 13% patients in Kunming). Over the entire 1-year period the median days of remaining in the program were 84 days (in Shanghai and Kunming were 317 days and 22 days).The factors associated with retention included age (HR = 0.98, 95%C.I.:0.96-0.99, P = 0.0062) and ASI alcohol scores (HR = 5.72, 95%C.I.:1.49-21.92, P = 0.0109) at baseline. One year retention of newly recruited patients with heroin dependence was related to age and ASI alcohol scores at baseline. The adherence is poorer for the patients who are young and having more serious alcohol problems.