Darker C D, Ho J, Kelly G, Whiston L, Barry J
Department of Public Health and Primary Care, Trinity Centre for Health Sciences, Trinity College Dublin, Tallaght Hospital, Dublin 24, Ireland.
Ir J Med Sci. 2016 May;185(2):433-41. doi: 10.1007/s11845-015-1314-5. Epub 2015 May 31.
Retention in Methadone Maintenance Treatment (MMT) is superior to that of other therapies for opioid addiction, but with international retention rates around 50 % after 1 year of treatment, there remains a need for improved retention rates.
This study aimed to explore the demographic and clinical factors predicting retention in MMT.
Face-to-face surveys with MMT patients in a Dublin methadone clinic were conducted. Retention was assessed by the presence and duration of breaks in treatment at any stage.
189 patients participated in the study. 46 % (n = 87) reported having at least one break in treatment, and the median duration of a break was 3 months. Age, current methadone dose and prescription of antipsychotic medication were significant predictors of retention. Patients who were older, single, living in their own home, on a higher dose of methadone, or taking antipsychotic medications had fewer breaks in treatment. Males tended to have significantly longer breaks. Patients reported that the main reasons for breaks were relapse into drug use (21.8 %, n = 19), incarceration (11.4 %, n = 10), weary of MMT (13.7 %, n = 12) or problems at the clinic (10.3 %, n = 9). Factors enabling regular attendance included wanting to get or stay clean (37.5 %, n = 51), avoidance of withdrawal symptoms (16.1 %, n = 22), methadone dependence (13.9 %, n = 19) and services provided (10.2 %, n = 14).
Patients who were older, single, living in their own home, on a higher dose of methadone, or taking antipsychotic medications had fewer breaks in treatment.
美沙酮维持治疗（MMT）在治疗阿片类药物成瘾方面比其他疗法效果更佳，但治疗1年后的国际留存率约为50%，仍有提高留存率的需求。
本研究旨在探索预测MMT留存率的人口统计学和临床因素。
对都柏林一家美沙酮诊所的MMT患者进行面对面调查。通过治疗任何阶段中断治疗的情况及持续时间评估留存率。
189名患者参与了研究。46%（n = 87）报告至少有一次治疗中断，中断的中位持续时间为3个月。年龄、当前美沙酮剂量和抗精神病药物处方是留存率的显著预测因素。年龄较大、单身、独自居住、服用较高剂量美沙酮或服用抗精神病药物的患者治疗中断较少。男性的治疗中断往往明显更长。患者报告治疗中断的主要原因是复吸（21.8%，n = 19）、监禁（11.4%，n = 10）、对MMT感到厌倦（13.7%，n = 12）或诊所出现问题（10.3%，n = 9）。促使定期就诊的因素包括想要戒毒或保持戒毒状态（37.5%，n = 51）、避免戒断症状（16.1%，n = 22）、美沙酮依赖（13.9%，n = 19）以及所提供的服务（10.2%，n = 14）。
年龄较大、单身、独自居住、服用较高剂量美沙酮或服用抗精神病药物的患者治疗中断较少。
