昭觉县美沙酮维持治疗门诊非重复入组者退出情况及影响因素分析

Dropout and its related factors among non-repeated clients of methadone maintenance treatment clinic in Zhaojue County

目的了解凉山州昭觉县美沙酮维持治疗门诊受治者退出治疗的情况,并探讨其影响因素。方法采用回顾性队列研究方法,以昭觉县2013年1月1日~2015年12月31日入组参加美沙酮维持治疗且仅有一个治疗阶段的吸毒人员为研究对象,对其人口学特征、毒品使用特征等进行描述性分析,并采用生存分析方法对维持治疗时间及退出治疗的影响因素进行分析。结果共纳入研究对象301例,维持治疗时间平均为(14.5±10.7)个月,中位数为15.1个月,截至观察终点,累积退出者占85.38%,维持治疗时间在1年及以上者占56.48%。Cox比例风险回归模型分析显示,文化程度、吸毒年限、是否注射吸毒、日均服药剂量是受治者退出治疗与否的影响因素(均有P<0.05)。结论昭觉县美沙酮维持治疗门诊仅一个治疗阶段受治者中退出人数较多,治疗效果欠佳。在今后的工作中,针对不同病人应采取不同措施,并通过适当增加服药剂量、加强随访工作,同时配合心理咨询和行为干预等措施减少退出。

Objective To explore the the situation of dropout of the drug users receiving methadone maintenance treatment （MMT） and its related factors in Zhaojue County, Liangshan Prefecture. Methods A retrospective cohort study was conducted on drug users enrolled from MMT clinics in Zhaojue County and who bad only one treatment stage from Janu- ary 1 st, 2013 to December 3 lth, 2015. Descriptive method was used to describe demographic characteristics, drug use be- haviors, etc. Factors affecting the situation of dropout were analyzed by survival analysis. Results A total of 301 drug us- ers were included in this study, the average duration of the drug users receiving MMT was 14. 5 -＋ 10. 7 months, and the median was 15.1 months. By the end of bbservation period, the rate of patients who withdrew from MMT was 85.38% and the rate of patients whose retention time was more than 1 year （ including 1 year） was 56. 48%. Cox proportional hazard re- gression modeling determined that the situation of dropout was associated with education level, the period of drug use, the history of injecting drug use and daily dosage （ all P 〈 0.05 ）. Conclusions There were more than half of maintenance treatment patients adhered to the period that MMT had an effect. In the later process, corresponding measures, such as in- creasing daily dosage, enhancement of education, psychological counseling and behavior intervention, should be taken to prolong retention time.