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越南胡志明市的美沙酮维持治疗:依从性的多维测量及相关因素

Methadone maintenance treatment in Ho Chi Minh City, Vietnam: Multidimensional measure of adherence and associated factors.

作者信息

Le Uyen Thanh Nu, Tran Thuan Thien, Le Giang Truong, Thai Truc Thanh

机构信息

Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.

Ho Chi Minh City Public Health Association, Ho Chi Minh City, Vietnam.

出版信息

Glob Public Health. 2022 Feb;17(2):313-323. doi: 10.1080/17441692.2020.1864750. Epub 2020 Dec 20.

Abstract

Medication adherence has become a major concern in methadone maintenance treatment (MMT) worldwide, but little is known about this in Vietnam. This study aimed to identify adherence level among outpatients at district clinics in Vietnam. A cross-sectional study of 450 MMT outpatients was conducted at three clinics in Ho Chi Minh City (HCMC). Participants underwent face-to-face interviews using a structured questionnaire. Adherence was measured based on both the number of doses missed under Vietnam Ministry of Health criteria and the level of perceived adherence using a visual analogue scale. The prevalence of adherence based on these measures was 61.8% and 80.9%, respectively. Significantly higher level of adherence was found in young participants who had used drug for a longer period of time, had comorbidity, were on antiretroviral therapy and satisfied with MMT service time. However, lower odds of adhering to MMT were found in participants with higher educational level who were married, spent more than 30 min to go to the clinic and currently used illicit drug. In conclusion, despite a relatively high prevalence of adherence, there were a large number of MMT non-adherence patients in HCMC. Interventions are needed to improve adherence and to enhance MMT programmes in Vietnam.

摘要

药物依从性已成为全球美沙酮维持治疗(MMT)中的一个主要问题,但在越南,对此了解甚少。本研究旨在确定越南地区诊所门诊患者的依从水平。在胡志明市(HCMC)的三家诊所对450名MMT门诊患者进行了一项横断面研究。参与者使用结构化问卷进行面对面访谈。依从性是根据越南卫生部标准下错过的剂量数以及使用视觉模拟量表的感知依从水平来衡量的。基于这些测量方法的依从率分别为61.8%和80.9%。在使用毒品时间较长、患有合并症、接受抗逆转录病毒治疗且对MMT服务时间满意的年轻参与者中,发现依从性水平显著更高。然而,在已婚、前往诊所花费超过30分钟且目前使用非法药物的高学历参与者中,坚持MMT的几率较低。总之,尽管依从率相对较高,但胡志明市仍有大量MMT不依从患者。需要采取干预措施来提高依从性,并加强越南的MMT项目。

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