中国云南省美沙酮维持治疗依从性差的预测因素
Predictors of Poor Adherence to Methadone Maintenance Treatment in Yunnan Province, China.
作者信息
Shen Jiucheng, Wang Mei, Wang Xiaodan, Zhang Guanbai, Guo Jie, Li Xinyue, Li Jianhua
机构信息
Yunnan Institute for Drug Abuse, Kunming, China (JS, XW, GZ, JG, XL, JL); National Addiction Centre, Division of Psychological Medicine and Psychiatry, Institute of Psychiatry, King's College, London, UK (MW).
出版信息
J Addict Med. 2016 Jan-Feb;10(1):40-5. doi: 10.1097/ADM.0000000000000180.
BACKGROUND
China initiated the methadone maintenance treatment (MMT) program since 2004. The main challenge has been poor clinic adherence, which has a serious impact on treatment efficacy.
OBJECTIVES
The aim of the study was to identify predictors of poor adherence to MMT in Yunnan Province, China.
METHODS
We performed a case-control study of 764 patients, newly enrolled or re-enrolled on MMT programs, between January 1, 2007 and December 31, 2011. Information was obtained from clinic databases.
RESULTS
The frequency of poor adherence was 561 (73.43%). Lower daily methadone dosage (<60 mg) was significantly associated with poor adherence (odds ratio 4.07; 95% confidence interval, 2.88-5.74; P value < 0.001). Younger age was also a significant predictor of poor adherence (odds ratio 1.04; 95% confidence interval, 1.01-1.05; P value < 0.01).
CONCLUSIONS
Higher dosage of methadone is recommended as a way to improve treatment adherence.
背景
中国自2004年起启动美沙酮维持治疗（MMT）项目。主要挑战在于诊所依从性差，这对治疗效果有严重影响。
目的
本研究旨在确定中国云南省美沙酮维持治疗依从性差的预测因素。
方法
我们对2007年1月1日至2011年12月31日期间新加入或重新加入美沙酮维持治疗项目的764名患者进行了病例对照研究。信息来自诊所数据库。
结果
依从性差的发生率为561例（73.43%）。每日美沙酮剂量较低（<60毫克）与依从性差显著相关（比值比4.07；95%置信区间，2.88 - 5.74；P值<0.001）。年龄较小也是依从性差的一个显著预测因素（比值比1.04；95%置信区间，1.01 - 1.05；P值<0.01）。
结论
建议增加美沙酮剂量以提高治疗依从性。
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