A qualitative study exploring the reason for low dosage of methadone prescribed in the MMT clinics in China
A qualitative study exploring the reason for low dosage of methadone prescribed in the MMT clinics in China
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DOI：
10.1016/j.drugalcdep.2011.01.004
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发表时间：
2011-08-01
影响因子：
4.2
通讯作者：
Detels, Roger
中科院分区：
文献类型：
--
作者：
Lin, Chunqing;Detels, Roger
目的：美沙酮维持治疗（MMT）剂量是影响美沙酮治疗保留的重要因素。与其他国家相比，中国的MMT客户接受的美沙酮剂量较低。本研究的目的是阐明美沙酮低剂量处方在MMT clinicsinChina.Methods的原因：二十八个服务提供者被招募从MMT诊所在浙江省和江西省，中国。定性深入访谈，以确定处方美沙酮在MMT clinics.Results的程序：在28个诊所规定的平均剂量为35毫克/人/天。确定了导致低剂量美沙酮的四个主要主题：（1）服务提供者担心大量服用美沙酮与其他物质混合使用可能导致过量死亡的责任，（2）缺乏对减少危害的理解，导致长期维持治疗方法的接受程度较低，（3）病人和服务提供者之间关于剂量调整的沟通中断;（4）大多数服务提供者认为减少剂量是治疗MMT相关副作用的有效方法。研究结果强调了制定明确的个体化剂量管理指南和改善中国MMT诊所服务提供者培训的必要性。(C)2011爱思唯尔爱尔兰有限公司保留所有权利。
Objectives: Dosage of methadone maintenance therapy (MMT) is an important factor influencing retention in methadone treatment. MMT clients in China received lower dosages of methadone compared with those provided in other countries. The objective of this study is to elucidate the reason for the low methadone dosage prescribed in MMT clinics in China.Methods: Twenty-eight service providers were recruited from the MMT clinics in Zhejiang and Jiangxi Provinces, China. Qualitative in-depth interviews were conducted to ascertain the procedure for prescribing methadone in the MMT clinics.Results: The average dosage prescribed in the 28 clinics was 35 mg/person/day. Four major themes resulting in low dosage of methadone were identified: (1) the service providers fear the liability resulting from large closes of methadone in combination with other substances which might result in overdose fatalities, (2) lack of understanding of harm reduction which resulted in low acceptance of the long term maintenance treatment approach, (3) break-down in communication between clients and service providers about dosage adjustment, and (4) dosage reduction is perceived by most service providers as an effective way to treat the side-effects associated with MMT.Conclusions: The findings of the study highlighted the necessity to formulate clear guidelines concerning individualized dosage management and to improve training among service providers' in MMT clinics in China. (C) 2011 Elsevier Ireland Ltd. All rights reserved.