美沙酮社区药物维持治疗门诊实施激励机制5年对门诊的影响

THE EFFECT OF 5-YEARS' IMPLEMENTATION OF INCENTIVE STRATEGY AT THE METHADONE MAINTENANCE TREATMENT CLINIC

目的:探讨在美沙酮社区药物维持治疗门诊对海洛因成瘾者实施激励机制对门诊的影响。方法:在美沙酮社区药物维持治疗门诊实施一整套激励措施,分析实施激励措施对门诊的影响。结果:实施激励机制后,门诊服药秩序明显好转,病人服药依从性提高。实施激励机制1a后病人服药率明显提高,与同期开诊的另外3家未实施激励机制的MMT门诊比较,其它3家门诊累计在治病人服药率仅为62.4%,而本门诊实施激励机制后,门诊服药率达到75.8%,服药率明显提高,具有显著统计学意义(P<0.01)。实施前治疗维持率88.9%,实施后治疗维持率达90.8%。实施激励机制对门诊管理带来正性影响,并且增加的支出在门诊可控范围内。结论:实施激励机制有利于提高患者参加维持治疗的依从性,提高治疗维持率及服药率。对于较长时间维持的服药者,激励机制对于促进患者坚持参加维持治疗,回归社会具有积极意义。

Objective： To explore the effect of incentive strategy for heroin addicts at the methadone maintenance treatment （MMT） clinic. Methods：The effect of the incentive strategy was analyzed after implementing a set of incentive measures at the MMT clinic. Results： After the implementation of incentive mechanism, the MMT clinic＇ s medication discipline was significantly improved, and heroin addicts were more compliant with medications. The medication - taking rate of the experimental clinic that under the incentive mechanism of 1 a, reached to 75.8% , and was significantly higher （ P 〈 0.01 ） than other 3 MMT clinics which didn＇ t implement the incentive mechanism, and the average medication - taking rate was only 62.4%. The treatment maintenance rate of the experimental clinic reached to 90. 8% after implementing the incentive mechanism, comparing with only 88.9% before the implementation. The incentive mechanism had a positive impact on the clinic management; meanwhile, the increase of expenditure was affordable and controllable by the clinic. Conclusion：The implementation of incentive mechanism at MMT clinic could improve patients＇ compliance to treatment, and increase the maintenance rate and medication -taking rate. For patients who need long- term treatment, incentive strategy has a positive impact on encouraging patients to persist in the maintenance treatment and re -assimilation into the society.