CAJ | 학술논문

目的了解美沙酮维持治疗(MMT)的受治者保持治疗率及其影响因素.方法采用队列研究设计,于2006年6-10月在贵州省8家MMT门诊选择1003名自愿参加调查、新进入MMT项目的海洛因成瘾者,以面对面访谈方式对影响MMT受治者保持治疗的因素进行问卷调查,并随访其保持治疗的情况至2007年6月.用Kaplan.Meier方法计算保持治疗率,Cox比例风险回归分析影响受治者保持治疗的因素.结果对MMT受治者的随访共持续14个月,受治者平均保持治疗时间为10个月,第6、12个月时的保持治疗率分别为68.8%、57.4%.受治者在不同MMT门诊、每日服用的美沙酮剂量和对MMT的认识是影响保持治疗的主要因素随着受治者每日服用美沙酮剂量的增加,其退出治疗的风险降低,剂量每增加25 mg,退出治疗的风险降低20%(风险比HR=0.80,P＜0.01).进入MMT时认为需要终生服用美沙酮的受治者比认为以后可以戒断美沙酮的受治者退出治疗的风险低(HR=0.66,P＜0.05).结论贵州省MMT受治者治疗12个月时只有近一半仍保持治疗;不同的MMT门诊、每日服用美沙酮剂量和对MMT的认识是影响保持治疗的主要因素.
목적 료해미사동유지치료(MMT)적수치자보지치료솔급기영향인소.방법 채용대렬연구설계,우2006년6-10월재귀주성8가MMT문진선택1003명자원삼가조사、신진입MMT항목적 해락인성은자,이면대면방담방식대영향MMT수치자보지치료적인소진행문권조사,병수방기보지치료적정황지2007년6월.용Kaplan.Meier방법계산보지치료솔,Cox비례풍험회귀분석영향수치자보지치료적인소.결과 대MMT수치자적수방공지속14개월,수치자평균보지치료시간위10개월,제6、12개월시적보지치료솔분별위68.8%、57.4%.수치자재불동MMT문진、매일복용적미사동제량화대MMT적인식시영향보지치료적주요인소수착수치자매일복용미사동제량적증가,기퇴출치료적풍험강저,제량매증가25 mg,퇴출치료적풍험강저20%(풍험비HR=0.80,P＜0.01).진입MMT시인위수요종생복용미사동적수치자비인위이후가이계단미사동적수치자퇴출치료적풍험저(HR=0.66,P＜0.05).결론 귀주성MMT수치자치료12개월시지유근일반잉보지치료;불동적MMT문진、매일복용미사동제량화대MMT적인식시영향보지치료적주요인소.
Objective To understand the situation of client-retention to methadone maintenance treatment(MMT)program and related factors.Methods A Cohon study was adopted.In toml,1003 heroin addicts who were treated at 8 local MMT clinics with less than one month period.were recruited under nominal informed consent from Guizhou province.southwest part of China.during June to October 2006.Face-to-face interview and questionnaire administered to collect relevant information from the clients who were also followed nntil June 2007 to understand the situation on retention.Data were analyzed with Kaplan-Meier method to estimate the retention rate at different time spans while factors related to retention were analyzed with Cox proportional hazard regression model.Results All the clients were followed-up for 14 months,with an average retention of ten months.The retention rates of the clients were 68.8%and 57.4%at 6th-month and 12th-month of the treatment program.estimated by Kaplan-Meier method.Results of Cox regression analysis showed that factors influencing retention rate on MMT among the clients,including their awareness on MMT,dailv dose of methadone intake,and difierent MMT clinics which they were attached to.Risk influencing the withdrawal from MMT had a 20%decrease along with the increase when the daily dose of methadone intake reached 25 mg,with a hazard ratio of 0.80(P＜0.01).If the clients were aware that methadone was a life-time treatment when they began the MMT program.the risk for withdrawal would be lower than those who were not and the hazard ratio became 0.66(P＜0.05).Conclusion Our data showed that about half of the clients who were at the MMT program would still stick to it after 12-months.suggesting that the retention rate was not satisfactory and need to be improved.Factors as the MMT clinics themselves that the clients visited,(Laily methadone dosage they took,and the awareness on MMT etc.were important predictors to the rate of retention on MMT program.