Joe G W, Simpson D D, Sells S B
Institute of Behavioral Research, Texas Christian University, Fort Worth.
Am J Drug Alcohol Abuse. 1994;20(2):173-97. doi: 10.3109/00952999409106781.
A general framework for studying drug abuse treatment process factors is presented, and components are then used to predict relapse to opioid use during treatment in methadone maintenance. Major domains of the treatment process research framework include client variables at entry, program characteristics, treatment events, and client outcomes. The analyses rely on the use of proportional hazards models to identify significant outcome predictors in a sample of 590 methadone maintenance clients from 21 clinics in the Research Triangle Institute/Treatment Outcome Prospective Study (RTI/TOPS) data system who remained in treatment at least 3 months. The analyses were performed on the total sample and separately on clients from three groups of clinics classified on the basis of the distribution of client relapse rates and tenure in treatment. Relapse rates were related to dosage level, client monitoring with urinalyses, and methadone take-home privileges in some clinics, and hence, these time-varying treatment events were important factors in treatment outcomes. Even at entry to treatment, some measures were found to be related to how the client later performed during treatment. Finally, it was also found that the particular area of professional speciality of the staff making client diagnosis at intake and preparing treatment plans was associated with client outcomes.
本文提出了一个研究药物滥用治疗过程因素的总体框架，然后利用该框架的组成部分来预测美沙酮维持治疗期间阿片类药物使用的复发情况。治疗过程研究框架的主要领域包括入组时的患者变量、项目特征、治疗事件和患者结局。分析依赖于比例风险模型的使用，以在来自研究三角研究所/治疗结果前瞻性研究（RTI/TOPS）数据系统中21家诊所的590名美沙酮维持治疗患者样本中识别显著的结局预测因素，这些患者至少接受了3个月的治疗。分析在总样本上进行，并分别对根据患者复发率分布和治疗期限分类的三组诊所的患者进行分析。复发率与剂量水平、通过尿液分析进行的患者监测以及某些诊所的美沙酮带回家特权有关，因此，这些随时间变化的治疗事件是治疗结局的重要因素。即使在开始治疗时，也发现一些指标与患者随后在治疗期间的表现有关。最后，还发现进行患者诊断和制定治疗计划的工作人员的专业领域与患者结局相关。
