Social and structural barriers for adherence to methadone maintenance treatment among Vietnamese opioid dependence patients.
Social and structural barriers for adherence to methadone maintenance treatment among Vietnamese opioid dependence patients.
复制标题
越南阿片类药物依赖患者遵守美沙酮维持治疗的社会和结构障碍。
DOI：
10.1371/journal.pone.0190941
复制
发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Latkin CA
中科院分区：
文献类型：
--
作者：
Tran BX;Nguyen LH;Tran TT;Latkin CA
美沙酮维持治疗（MMT）服务可以降低艾滋病毒传播的风险，如果病人完全坚持治疗。识别依从性模式和潜在的相关因素对于越南MMT计划的可持续性至关重要。本研究探讨了社会和结构因素与患者之间的不同服务提供模式的MMT坚持。在河内的三个MMT诊所共510名患者进行了采访。自我报告的依从性指标包括过去7天内漏服剂量的次数和过去30天内的依从性水平，使用视觉模拟量表（VAS）评分，评分范围为0（不依从）至100（完全依从）。采用多元回归分析确定与不依从MMT相关的因素。共有17.7%的受试者报告在过去30天内不完全依从MMT，8.3%的受试者报告在过去7天内漏服一次剂量。感染艾滋病毒/艾滋病、自我护理和日常活动差以及向配偶或亲密伴侣透露健康问题与不依从有关。那些疼痛或抑郁的患者更有可能报告更好的依从性。向配偶/伴侣透露健康状况会增加不完全依从的风险，而向朋友透露会减少过去七天内错过剂量的数量。与仅接受MMT和一般医疗保健的诊所相比，接受综合服务诊所的患者依从性VAS评分较低。维持患者对MMT的依从性是越南这项服务迅速扩展的主要原因。有必要解决吸毒者医疗保健需求的复杂性，他们难以康复到劳动力和社会，以及污名化，以最大限度地提高MMT计划的成果。
Methadone maintenance treatment (MMT) services may reduce the risk of HIV transmission if patients completely adhere to the treatment. Identifying adherence patterns and potential related factors is vital for the sustainability of MMT program in Vietnam. This study examined social and structural factors associated with adherence to MMT among patients in different service delivery models. A total of 510 patients at three MMT clinics in Hanoi were interviewed. Measures of self-reported adherence included the number of missed doses in the past 7 days and the level of adherence in the past 30 days using a visual analog scale (VAS) scoring from 0 (non-adherence) to 100 (perfect adherence). Multivariate regressions were employed to identify factors associated with non-adherence to MMT. A total of 17.7% of participants reported incomplete MMT adherence in the last 30 days and 8.3% reported missing a dose in the last seven days, respectively. Living with HIV/AIDS, poor self-care and usual activities, and disclosure of health issues to spouses or intimate partners were associated with non-adherence. Those patients with pain or depression were more likely to report better adherence. Disclosing health status to spouse/partner increased the risk of incomplete adherence, while disclosing to friends reduced the number of missed dose in the last seven days. Patients attending clinics with comprehensive services had a lower VAS score of adherence compared to those enrolling in clinics with only MMT and general health care. Sustaining the compliance of patients to MMT is principal in the rapid expansion of this service in Vietnam. It is necessary to address the complexity of health care demands of drug users, their difficulties to be rehabilitated into workforce and society, and the stigmatization to maximize the outcomes of MMT program.
登录
查看更多内容
影响因子：
3.6
作者：
Tran BX;Nguyen LH;Nong VM;Nguyen CT
通讯作者：
Nguyen CT
一项关于互联网成瘾和在线人际关系影响对越南与健康相关的生活质量的影响的研究。
影响因子：
4.5
作者：
Tran BX;Huong LT;Hinh ND;Nguyen LH;Le BN;Nong VM;Thuc VT;Tho TD;Latkin C;Zhang MW;Ho RC
通讯作者：
Ho RC
影响因子：
1.8
作者：
Latkin, Carl A.;Nguyen Vu Tuyet Mai;Go, Vivian F.
通讯作者：
Go, Vivian F.
影响因子：
2.7
作者：
Latkin, CA;Knowlton, AR;Mandell, W
通讯作者：
Mandell, W
影响因子：
2.3
作者：
Greenwald, MK
通讯作者：
Greenwald, MK