Hubbard Robert L, Craddock S Gail, Anderson Jill
Institute for Community-Based Research, National Development and Research Institutes, Inc. 940 Main Campus Drive, Suite 140 Raleigh, NC 27606, USA.
J Subst Abuse Treat. 2003 Oct;25(3):125-34. doi: 10.1016/s0740-5472(03)00130-2.
Followup results from the Drug Abuse Treatment Outcome Studies (DATOS) 1-year and 5-year followups were used to describe the long-term outcomes of drug treatment and to further clarify the relationship between treatment duration and post-treatment outcomes in four treatment modalities: outpatient methadone, long-term residential (LTR), outpatient drug free (ODF), and short-term inpatient. Methods replicating those used in earlier analyses of the DATOS 1-year followup of 2,966 patients admitted to treatment in 1991-1993 and those of the Treatment Outcome Prospective Study patients admitted in 1979-1981 were employed. DATOS is a non-experimental longitudinal study conducted within the natural settings of 96 treatment programs in the U.S.A. The study followed patients during and after treatment at specified periods of time. Prevalence of drug use and behaviors were evaluated for the year prior to treatment; and the post-treatment time frames defined by the 1- and 5-year followups. In addition, the multivariate analytic technique of generalized estimating equations was used to examine the relationship of treatment duration and outcomes across both followups while also controlling for patient characteristics and pretreatment levels of behaviors. The 5-year stratified followup sample included 1,393 of the same individuals in the 1-year followup sample. Analyses were restricted to patients participating in both followups. Reductions in prevalence of cocaine use in the year after treatment (compared to the preadmission year) by patients were associated with longer treatment durations (particularly 6 months or more in LTR and ODF). In addition, reductions in illegal activity and increases in full-time employment were related to treatment stays of 6 months or longer for patients in LTR. The DATOS results from the 1-year and 5-year post-treatment followup combined suggest the stability of outcomes of substance abuse treatment. While results are generally consistent with the full 1-year followup, reduced sample size and bias of the sample toward patients with longer treatment retention may have attenuated the findings.
药物滥用治疗结果研究（DATOS）的1年和5年随访结果被用于描述药物治疗的长期效果，并进一步阐明四种治疗方式（门诊美沙酮治疗、长期住院治疗（LTR）、门诊戒毒治疗（ODF）和短期住院治疗）的治疗时长与治疗后效果之间的关系。采用了与早期对1991 - 1993年接受治疗的2966名患者的DATOS 1年随访分析以及1979 - 1981年接受治疗的治疗结果前瞻性研究患者分析中所使用的方法。DATOS是一项在美国96个治疗项目的自然环境中开展的非实验性纵向研究。该研究在特定时间段内对患者治疗期间及治疗后的情况进行跟踪。评估了治疗前一年的药物使用及行为的流行情况，以及由1年和5年随访所定义的治疗后时间范围。此外，使用广义估计方程的多变量分析技术来检验两次随访中治疗时长与效果之间的关系，同时控制患者特征和行为的治疗前水平。5年分层随访样本包括1年随访样本中的1393名相同个体。分析仅限于参与两次随访的患者。治疗后一年（与入院前一年相比）患者可卡因使用流行率的降低与更长的治疗时长相关（特别是在LTR和ODF中为6个月或更长时间）。此外，对于LTR中的患者，非法活动的减少和全职工作的增加与6个月或更长时间的治疗停留有关。DATOS 1年和5年治疗后随访的综合结果表明药物滥用治疗效果的稳定性。虽然结果总体上与完整的1年随访一致，但样本量的减少以及样本对治疗保留时间较长患者的偏向性可能削弱了研究结果。
