Predictors of methadone treatment retention from a multi-site study: a survival analysis.
Predictors of methadone treatment retention from a multi-site study: a survival analysis.
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DOI：
10.1016/j.drugalcdep.2011.01.008
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发表时间：
2011-09-01
影响因子：
4.2
通讯作者：
Schwartz, Robert P.
中科院分区：
文献类型：
--
作者：
Kelly, Sharon M.;O'Grady, Kevin E.;Mitchell, Shannon Gwin;Brown, Barry S.;Schwartz, Robert P.
较长的美沙酮治疗期限与减少吸毒和犯罪、艾滋病毒血清转换和过量死亡等积极结果有关。对351名新进入马里兰州巴尔的摩美沙酮计划之一的阿片类药物依赖者的治疗中的保留进行了检查。COX比例风险回归用于根据基线ASI综合评分和治疗动机量表预测在治疗中保留的天数至90天。第二项分析使用相同的基线变量加上3个月的动机量表、患者满意度量表和美沙酮剂量对248名持续治疗至少3个月的患者进行预测，预计治疗天数为365天。分析表明，性别、种族、年龄、参与者是否有经常吸食可卡因的历史、参与者是否在假释/缓刑期间以及项目地点保持不变。90天的保留率由女性和较高的基线治疗准备(p=.005)和较低的求助意愿(p=.010)预测。较高的ASI医疗综合评分(p=.037)和较低的法律综合评分(p=.039)、较高的3个月治疗满意度评分(p=.008)和较高的剂量(p=.046)预测了365天的保留时间。3个月时对治疗的满意度较高是12个月保留率的显著预测因素，这表明了解满意度在决定保留率中所起的作用的重要性。更严重的法律问题与更短的保留时间相关，这表明增加对刑事司法患者服务的计划努力(例如，法律咨询)可能构成治疗的有益补充。
Longer tenure in methadone treatment has been associated with positive outcomes such as reductions in drug use and crime, HIV seroconversion, and overdose death. Retention in treatment was examined for 351 opioid-dependent individuals who had been newly admitted to one of six methadone programs in Baltimore, Maryland. Cox proportional hazards regression was used to predict number of days retained in treatment to 90 days from baseline ASI Composite scores and Treatment Motivation scales. A second analysis predicted days in treatment to 365 days using the same baseline variables plus 3-month Motivation scales, Patient Satisfaction scales, and methadone dose in the 248 individuals who had remained in treatment at least 3 months. Analyses held constant gender, race, age, whether participants had a history of regularly smoking cocaine, whether participants were on parole/probation, and program site. Retention at 90 days was predicted by female gender, and greater baseline Treatment Readiness (p=.005) but lower Desire for Help (p=.010). Retention at 365 days was predicted by higher baseline ASI Medical Composite scores (p=.037) and lower Legal Composite scores (p=.039), higher 3-month Treatment Satisfaction scores (p=.008), and higher dose (p=.046). Greater satisfaction with treatment at 3 months was a significant predictor of retention at 12 months, indicating the importance of understanding the role satisfaction plays in determining retention. Greater severity of legal problems was associated with shorter retention, suggesting that program efforts to increase services to criminal justice patients (e.g., legal counseling) may constitute a useful addition to treatment.
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影响因子：
3.9
作者：
Berkman, Nancy D.;Wechsberg, Wendee M.
通讯作者：
Wechsberg, Wendee M.
影响因子：
2.7
作者：
Kelly, Sharon M.;Schwartz, Robert P.;Brown, Barry S.
通讯作者：
Brown, Barry S.
DOI：
10.1136/bmj.c5475
发表时间：
2010-10-26
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Cornish, Rosie;Macleod, John;Hickman, Matt
通讯作者：
Hickman, Matt
影响因子：
1.7
作者：
Grella, CE;Wugalter, SE;Anglin, MD
通讯作者：
Anglin, MD
影响因子：
1.9
作者：
MCLELLAN, AT;LUBORSKY, L;OBRIEN, CP
通讯作者：
OBRIEN, CP