美沙酮维持治疗脱失的相关因素和认知情况分析

Dropping-out rate of patients with methadone maintenance treatment and associated factors,and the analysis on awareness and cognition of these patients

目的了解美沙酮维持治疗门诊服药人员的脱失率及相关影响因素,并调查其维持治疗的认知情况。方法本研究为一项前瞻性队列研究,经知情同意后,对符合纳入标准的研究对象开展基线调查收集人口学、吸毒行为、维持治疗等信息,并进行为期6个月的随访。结果本研究共纳入515例研究对象,在6个月的随访期间,213例(41.4%)研究对象发生脱失。不同婚姻状况研究对象脱失率差异有显著性(x^2=11.86,P=0.01),已婚或再婚研究对象脱失率较低。部分维持治疗人员对治疗的认知不全面。结论提高治疗维持率是现阶段维持治疗工作的重点内容之一,为维持治疗人员提供社会支持和心理干预,尤其是获取家庭的参与和支持,可以降低脱失率。应考虑对维持治疗人员进行宣传教育,使其心理上接受长期维持治疗的模式。

Objective To learn the dropping-out rate among outpatients who participated in methadone maintenance treatment （ MMT ） and associated risk factors, and to investigate the awareness and cognition of these patients. Method The study was a prospective cohort study. After informed consent, a baseline survey was conducted to collect demographic, drug use, and MMT information etc among these subjects who met the inclusion criteria. All the en- rolled subjects were follow-up for 6 months. Result A total of 515 subjects were enrolled into the study, in which 213 （41.4%） subjects dropped-out during 6 months of follow-up. There was significant difference in dropping-out rate among subjects with different marital status（x^2 = 11.86, P = 0.01 ） , with lower dropping-out rate among subjects in marriage. Some subjects had incorrect awareness and cognition on MMT. Conclusion Improving the maintainance rate of treatment is one of main contents in current MMT work. Providing social support and psychological interven- tion for MMT patients, especially involving in family participation and support,is useful in lowering the dropping-out rate. Publicity and education can be conducted among MMT patients, so that they can psychologically accept the mode of long-term treatment in.