镇江市社区药物维持治疗门诊患者脱失原因分析及干预对策

ANALYSIS ON REASONS AND INTERVENTION MEASURE FOR DROP OUT OF METHADONE MAINTENANCE TREATMENT IN ZHENJIANG

目的:了解社区药物维持治疗门诊患者脱失的原因及影响依从性的因素,为提高服药率及依从性提供依据。方法:使用统一设计的脱失原因调查表,采取电话询问、家庭随访等多种方式,对在2006年3月-2013年12月期间镇江市美沙酮门诊部388例脱失患者进行调查、统计分析;并与252例在服人员的人口学资料进行比较,分析服药人员脱失的主要原因及影响依从性的因素。结果:388例脱失病人占总治疗人数的60.6%(388/640),其中:偷吸毒品被抓99例(25.5%),发生刑事案件被抓104例(26.8%),家庭变故、生病生育及经济等引起脱失50例(12.9%),自称自然戒断毒品有43例(11.1%),治疗期间死亡5例(1.3%),外出打工、居住或原因不明等综合因素共87例(22.4%)。年轻的、单身、男性、无业、文化程度低及无家人支持等是影响维持治疗依从性、造成脱失的危险因素。结论:在脱失人员中,偷吸被抓、刑事案件被抓及原因不明等是脱失的主要原因。为了提高服药人员的依从性,降低脱失率,提高服药率,需针对不同原因及影响依从性的危险因素,采取不同的干预措施和对策。

Obective： To understand the reasons for drop out of methadone maintenance treatment （MMT） in Zhenjiang and provide scientific data for raising the retention rate of MMT patients and reducing drop out rate. Methods： A standard questionnaire survey was carried out in the drop out population of MMT during Mar. 2006 to Dec. 2013 in Zhenjiang MMT clinics by telephone call or follow- up. The demographic data between the drop out group and retention group of MMT was compared. Results：Ahogether 388 cases had the experience of drop out from MMT, accounting for 60. 6% of the total number on MMT （388/640）. The main reasons for drop out included： 99 cases used drugs again and returned to compulsory treatment （ 25. 5% ）, 104 cases were arrested for crimes （26.8%） ; 43 cases droped out for drug free （ 11.1% ） ; 5 cases drop out for ill or dead （ 1.3% ）. Fifty cases drop out for difficulty in domestic economy, lack of money for MMT （12.9%） ; 89 cases drop out for other reasons, such as living outside of Zhenjiang （22.4%） . The main reasons of drop out of MMT included ： young, single, male, out of work, poor knowledge and no family supports. Conclusion： Relapse to drug use and arreste for crime are main reasons for drop out from MMT. It is necessary to develop comprehensive intervention strategy, in order to reduce drop out rate.