Faculty of Pharmaceutical Management and Economics, Hanoi University of Pharmacy, 13-15 Le Thanh Tong, Hoan Kiem District, Hanoi City, 111000, Vietnam.
Harm Reduct J. 2024 Jul 3;21(1):129. doi: 10.1186/s12954-024-01040-8.
This multicenter, cross-sectional study was conducted to investigate the prevalence of treatment non-adherence and its associated factors among methadone maintenance patients in Vietnam.
This secondary data analysis was conducted using the data from a previous study. Six hundred patients were interviewed face-to-face to collect data on their demographic characteristics and social support. Information about the treatment characteristics and patients' non-adherence was gathered from medical records and books monitoring their treatment process. Treatment non-adherence was defined as missing at least one methadone dose in the last three months.
The overall prevalence of non-adherence was 45.7%. The average social support score of patients who completely adhered to treatment was significantly higher than that of those who did not (p < 0.001). In the multivariate logistic regression model, for each one-unit increase in social support (one score), treatment time (a year), and patient's monthly income (one million Vietnam dongs), the odds of non-adherence decreased by 28% (aOR = 0.72, 95%CI 0.59-0.88, p = 0.002), 15% (aOR = 0.85, 95%CI 0.80-0.91, p < 0.001) and 9% (aOR = 0.91, 95%CI 0.85-0.97, p = 0.004), respectively. Patients living in Son La (a mountainous province) were 1.72 times (95%CI 1.09-2.71) more likely to be non-adherent as compared to those in other areas (p = 0.020). As per univariate analyses, other associated factors could be age, education level, family monthly income, occupation, and opioid relapse (p < 0.001).
A high non-adherence rate was found among Vietnamese methadone maintenance patients. Interventions involving social support, occupation, income, and education are needed to improve their treatment adherence.
本多中心、横断面研究旨在调查越南美沙酮维持治疗患者治疗不依从的发生率及其相关因素。
本二次数据分析使用了先前研究的数据。对 600 名患者进行了面对面访谈,以收集其人口统计学特征和社会支持的数据。从医疗记录和书籍中收集了有关治疗特征和患者不依从的信息,以监测他们的治疗过程。治疗不依从被定义为在过去三个月中至少漏服一剂美沙酮。
总体不依从率为 45.7%。完全依从治疗的患者的平均社会支持评分明显高于不依从的患者(p<0.001)。在多变量逻辑回归模型中,社会支持每增加一个单位(一个评分)、治疗时间(一年)和患者每月收入(一百万越南盾),不依从的可能性分别降低 28%(调整比值比[aOR] = 0.72,95%置信区间[CI] 0.59-0.88,p=0.002)、15%(aOR = 0.85,95%CI 0.80-0.91,p<0.001)和 9%(aOR = 0.91,95%CI 0.85-0.97,p=0.004)。与其他地区的患者相比,居住在 Son La 省(一个山区省份)的患者不依从的可能性高 1.72 倍(95%CI 1.09-2.71,p=0.020)。根据单变量分析,其他相关因素可能是年龄、教育水平、家庭月收入、职业和阿片类药物复发(p<0.001)。
越南美沙酮维持治疗患者的不依从率较高。需要采取社会支持、职业、收入和教育干预措施来提高他们的治疗依从性。