Simpson D D, Joe G W, Rowan-Szal G A
Institute of Behavioral Research, Texas Christian University, Fort Worth 76129, USA.
Drug Alcohol Depend. 1997 Sep 25;47(3):227-35. doi: 10.1016/s0376-8716(97)00099-9.
After finding that retention in methadone treatment for a year or longer was a highly significant predictor of patient outcomes following discharge, measures of pretreatment motivation and early therapeutic engagement were examined as predictors of program retention. Personal interviews were conducted with a sample of 435 patients 12 months after discharge from three methadone treatment programs. Logistic regression results showed several patient attributes--i.e. over 35, lower injection frequency before admission, and higher motivation for treatment--were each associated with twofold increases in the likelihood of having favorable follow-up outcomes on illicit drug use, alcohol use, and criminal involvement. Patients staying in treatment a year or longer, however, were nearly five times more likely to have better outcomes. Further analyses established that length of treatment stay was predicted by higher patient motivation at intake and early program involvement. The findings suggest that more comprehensive models of patient attributes, therapeutic process, and environmental influences are needed, and that treatment enhancement efforts should focus on such during-treatment measures as interim criteria for improving posttreatment outcomes.
在发现接受美沙酮治疗一年或更长时间是出院后患者治疗结果的一个高度显著预测因素后，对治疗前动机和早期治疗参与度的指标进行了研究，以作为项目留存率的预测因素。对来自三个美沙酮治疗项目出院12个月后的435名患者样本进行了个人访谈。逻辑回归结果显示，几个患者特征——即35岁以上、入院前注射频率较低以及治疗动机较高——各自与在非法药物使用、酒精使用和犯罪参与方面获得良好随访结果的可能性增加两倍相关。然而，接受治疗一年或更长时间的患者获得更好结果的可能性几乎高出四倍。进一步分析表明，治疗停留时间长短可通过患者入院时较高的动机和早期参与项目来预测。研究结果表明，需要更全面的患者特征、治疗过程和环境影响模型，并且治疗强化努力应侧重于诸如改善治疗后结果的中期标准等治疗期间措施。
