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美沙酮维持治疗中患者对美沙酮剂量充足性的认知:感知参与剂量决策的作用。

Patient perception of methadone dose adequacy in methadone maintenance treatment: The role of perceived participation in dosage decisions.

作者信息

Trujols Joan, González-Saiz Francisco, Manresa María José, Alcaraz Saul, Batlle Francesca, Duran-Sindreu Santiago, Pérez de Los Cobos José

机构信息

Addictive Behaviours Unit, Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain; Biomedical Research Networking Center on Mental Health (CIBERSAM), Barcelona, Spain.

Community Mental Health Unit of Villamartín, Mental Health Clinical Management Unit of Hospital de Jerez de la Frontera, Northern Area Health Management of Cádiz, Andalusian Health Service, Spain; Addictive Disorders Network (RTA), Granada, Spain.

出版信息

Patient Educ Couns. 2017 May;100(5):981-986. doi: 10.1016/j.pec.2016.12.001. Epub 2016 Dec 12.

Abstract

OBJECTIVE

In clinical practice, methadone maintenance treatment (MMT) entails tailoring the methadone dose to the patient's specific needs, thereby individualizing treatment. The aim of this study was to identify the independent factors that may significantly explain methadone dose adequacy from the patient's perspective.

METHOD

Secondary analysis of data collected in a treatment satisfaction survey carried out among a representative sample of MMT patients (n=122) from the region of La Rioja (Spain). As part of the original study protocol, participants completed a comprehensive battery to assess satisfaction with MMT, psychological distress, opinion of methadone as a medication, participation in dosage decisions, and perception of dose adequacy.

RESULTS

Multivariate binary logistic regression showed that the only variable independently associated with the likelihood of a patient perceiving methadone dose as inadequate was the variable perceived-participation in methadone dosage decisions (OR=0.538, 95% CI=0.349-0.828).

CONCLUSION

Patient participation in methadone dosage decisions was predictive of perceived adequacy of methadone dose beyond the contribution of other socio-demographic, clinical, and MMT variables.

PRACTICE IMPLICATIONS

Patient participation in methadone dosage decision-making is valuable for developing a genuinely patient-centred MMT.

摘要

目的

在临床实践中,美沙酮维持治疗(MMT)需要根据患者的具体需求调整美沙酮剂量,从而实现个体化治疗。本研究的目的是从患者角度确定可能显著解释美沙酮剂量充足性的独立因素。

方法

对从西班牙拉里奥哈地区的MMT患者代表性样本(n = 122)中收集的治疗满意度调查数据进行二次分析。作为原始研究方案的一部分,参与者完成了一套综合测评,以评估对MMT的满意度、心理困扰、对美沙酮作为药物的看法、参与剂量决策情况以及对剂量充足性的认知。

结果

多变量二元逻辑回归显示,与患者认为美沙酮剂量不足可能性独立相关的唯一变量是参与美沙酮剂量决策这一变量(比值比=0.538,95%置信区间=0.349 - 0.828)。

结论

患者参与美沙酮剂量决策可预测美沙酮剂量的充足性认知,其作用超过其他社会人口学、临床和MMT变量的影响。

实践意义

患者参与美沙酮剂量决策对于开展真正以患者为中心的MMT具有重要价值。

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