Chen Ang, Xia Ying-hua, Chen Wen, Ling Li, Tan Wen-kang, Zheng Rong-jia
School of Public Health Sun Yat-sen University, Guangzhou 510080, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2009 Dec;30(12):1230-3.
To identify predictors of treatment retention problems at the two initial methadone maintenance treatment (MMT) clinics in Guangdong province, and to provide reference in reducing the rate of drop-outs.
All of the patients were investigated at baseline and followed during the treatment period. Kaplan-Meier method on Survival Analysis was used to analyze retention related factors and predictors.
509 subjects were recruited in this study with median of retention time as 108 days (95%CI: 74 - 142 days). The retention rate at 1-, 3-, 6-, 12-months were 75.9%, 52.7%, 41.6%, 30.1%, respectively. Data from Multivariate Cox Proportional Hazard Model analysis showed predictors of retention would involve factors as HIV infection state at baseline (HR = 1.241, P = 0.047), daily methadone dose (HR = 0.633, P = 0.004) and secretly using drugs during treatment period (HR = 5.345, P = 0.000).
The retention rates at the two initial MMT clinics in Guangdong province were low. Patients who were HIV negative at baseline but still secretly using heroine during treatment or accepted low daily average dosage of methadone, had the tendency to drop out. The results implied that retention time could be prolonged by increasing daily methadone dosage.
确定广东省两家初始美沙酮维持治疗(MMT)诊所治疗维持问题的预测因素,并为降低脱落率提供参考。
所有患者在基线时接受调查,并在治疗期间进行随访。采用生存分析中的Kaplan-Meier方法分析维持相关因素和预测因素。
本研究共纳入509名受试者,维持时间中位数为108天(95%CI:74 - 142天)。1个月、3个月、6个月、12个月时的维持率分别为75.9%、52.7%、41.6%、30.1%。多变量Cox比例风险模型分析数据显示,维持的预测因素包括基线时的HIV感染状态(HR = 1.241,P = 0.047)、每日美沙酮剂量(HR = 0.633,P = 0.004)以及治疗期间秘密使用毒品(HR = 5.345,P = 0.000)。
广东省两家初始MMT诊所的维持率较低。基线时HIV阴性但在治疗期间仍秘密使用海洛因或每日平均美沙酮剂量较低的患者有脱落倾向。结果表明,增加每日美沙酮剂量可延长维持时间。