From the Department of Public Health (X Wei, L Wang, X Wang), Xi'an Jiaotong University; Xi'an Center for Disease Control (X Wei, H Li, J Li); and First Clinic of Xi'an Mental Health Center (W Jia), Xi'an, Shaanxi, China.
J Addict Med. 2013 Sep-Oct;7(5):342-8. doi: 10.1097/ADM.0b013e31829da05b.
We analyzed a 6-year methadone maintenance treatment (MMT) retention rate in 8 MMT clinics in Xi'an and the factors that influenced the retention rate.
We conducted a 6-year retrospective dynamic cohort study of 5849 eligible patients from 2006 to 2011. Participants were serially enrolled on the basis of opioid addiction, age, residence status, and civil capacity. Cumulative retention in treatment was calculated using survival analyses (life tables) on the basis of the number of days in MMT. We also used the Cox proportional hazard regression model to analyze the factors that may influence treatment retention.
The MMT retention varied from a less than 1 month to a maximum of 71.2 months; the average dose was 48.76 ± 17.03 mg/d. The cumulative retention for 12, 24, 36, 48, 60, and 72 months after MMT initiation were 0.87, 0.76, 0.66, 0.57, 0.49, and 0.43, respectively. The MMT retention rate was significantly associated with factors that included the particular clinic for MMT, the year when the subject initiated MMT, average daily dose, hidden drug use, sex, age, length of drug abuse history, needle sharing, living arrangements, and employment status.
The 6-year retention rates for MMT in the 8 clinics in Xi'an were higher than those reported in other studies of other clinics. High therapeutic doses (>60 mg/d) could reduce the risk of patients withdrawing from treatment. Retention rates were relatively high in cohorts who were elderly, living with family, employed, or drug users, especially those with a long history of drug abuse.
分析西安市 8 家美沙酮维持治疗（MMT）门诊 6 年的维持治疗保持率及其影响因素。
采用 2006-2011 年符合条件的 5849 名患者的 6 年回顾性动态队列研究。根据阿片类药物成瘾、年龄、居住状况和民事能力对参与者进行连续入组。根据 MMT 天数，用生存分析（寿命表）计算治疗的累计保持率。我们还使用 Cox 比例风险回归模型分析可能影响治疗保持的因素。
MMT 保持率从不到 1 个月到最长 71.2 个月不等；平均剂量为 48.76±17.03mg/d。MMT 治疗开始后 12、24、36、48、60 和 72 个月的累积保持率分别为 0.87、0.76、0.66、0.57、0.49 和 0.43。MMT 保持率与特定的 MMT 门诊、受检者开始 MMT 的年份、平均日剂量、隐性药物使用、性别、年龄、药物滥用史、共用针头、居住安排和就业状况等因素显著相关。
西安市 8 家门诊 6 年 MMT 保留率高于其他诊所的研究报告。高治疗剂量（>60mg/d）可降低患者退出治疗的风险。在年龄较大、与家人同住、就业或吸毒者的队列中，保留率相对较高，尤其是那些有较长吸毒史的人。
