Effectiveness of Methadone Maintenance Therapy and Improvement in Quality of Life Following a Decade of Implementation
Effectiveness of Methadone Maintenance Therapy and Improvement in Quality of Life Following a Decade of Implementation
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DOI：
10.1016/j.jsat.2016.07.006
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发表时间：
2016-10-01
影响因子：
3.9
通讯作者：
Danaee, Mahmoud
中科院分区：
文献类型：
--
作者：
Fei, Joni Teoh Bing;Yee, Anne;Danaee, Mahmoud
美沙酮维持治疗已被发现是一种有效的减少阿片类药物使用障碍的危害的治疗。然而，其在较长治疗时间内的益处的证据是有限的，因为大多数研究都集中在其短期益处上。由于美沙酮维持治疗在马来西亚实施已有十年，本研究旨在研究美沙酮治疗的有效性，自进入美沙酮治疗以来患者生活质量的变化，以及预测生活质量变化幅度的因素。这项研究发现，美沙酮维持治疗在减少海洛因使用、注射行为和犯罪方面是有效的，在改善社会功能和身体症状方面是有效的，但在减少与性有关的艾滋病毒风险行为方面却无效。虽然患者在随访时的生活质量明显好于进入美沙酮维持治疗时，但随着治疗时间的增加，生活质量的改善并不明显。年龄在50岁以上，人类免疫缺陷病毒（HIV）阳性状态和身体症状预测基线和随访之间的生活质量改善较差。另一方面，与非B型肝炎患者相比，B型肝炎患者在社会关系领域的生活质量改善更大。总之，美沙酮维持治疗是阿片类药物使用障碍的有效治疗方法，可改善生活质量，但其在治疗十年后进一步改善生活质量的益处需要进一步评估。(C)2016 Elsevier Inc. All rights reserved.
Methadone maintenance therapy has been found to be an effective harm reduction treatment for opioid use disorder. However evidence of its benefits over a longer duration of treatment is limited as most studies focus on its short term benefits. As methadone maintenance therapy reaches a decade since its implementation in Malaysia, this study sought to examine the effectiveness of methadone treatment, change in quality of life among patients since entry to methadone treatment, as well as factors predicting the magnitude of change in quality of life. This study found that methadone maintenance therapy was effective in reducing heroin use, injecting practices and crime, and in improving in social functioning and physical symptoms, but not in reducing sex-related HIV risk taking behavior. Though patients had a significantly better quality of life at follow-up than at entry to methadone maintenance therapy, the improvement in quality of life was not significantly greater as the duration of treatment increased. Age above 50 years old, human immunodeficiency virus (HIV) positive status and physical symptoms predicted a poorer improvement in quality of life between baseline and follow-up. On the other hand, patients with hepatitis B showed a greater improvement in quality of life in the social relationships domain compared to patients without hepatitis B. In conclusion, methadone maintenance therapy is an effective treatment for opioid use disorder and improves quality of life but its benefits in further improving quality of life beyond a decade of treatment need further evaluation. (C) 2016 Elsevier Inc. All rights reserved.