福建省美沙酮维持治疗者脱失影响因素

The influencing factors of dropping⁃out rate of methadone maintenance treatment in Fujian province

目的分析福建省美沙酮位置治疗者治疗时间及脱失影响因素。方法在福建省五个地市6家MMT门诊开展问卷调查,对所收集的信息进行整理分析,运用生存分析研究脱失的影响因素。结果截至2019年10月31日,510例受治者平均治疗时间为(128.78±2.04)个月,脱失率45.88%,对门诊服务一般/不满意者脱失风险高于满意者(P=0.001,95.0%CI=1.36~3.59),最近一次尿检结果阳性者脱失风险高于阴性者(P<0.001,95.0%CI=1.31~5.51),独居者脱失的风险高于非独居者的(P=0.007,95.0%CI=1.15~2.45)。结论福建省MMT的脱失率较高,应提高美沙酮治疗门诊的服务质量,治疗期间加强吗啡尿检,关注尿检阳性者,还应加强与家人朋友的沟通协调,减少受治者独居的情况,降低脱失率。

Objective To analyze the influence factors of treatment time and dropping⁃out rate of methadone location therapy in Fujian province.Methods A questionnaire survey was conducted in six MMT clinics in five cities of Fujian province,The collected information was sorted out and analyzed,Survival analysis was used to study the influencing factors of dropping⁃out rate.Results As of October 31,2019,the average treatment time of 510 patients was(128.78±2.04)months,and the dropping⁃out rate was 45.88%.The risk of dropping⁃out patients with general/unsatisfactory outpatient service was higher than that of patients with satisfactory outpatient service(P=0.001,95.0%confidence interval:[95%CI]=1.36 to 3.59)times.The risk of dropping⁃out was higher in patients with positive results in the last urine test than in those with negative results(P<0.001,95.0%CI=1.31⁃5.51).The risk of dropping⁃out was higher in those who lived alone than in those who did not(P=0.007,95.0%CI=1.15⁃2.45).Conclusion The dropping⁃out rate of MMT in Fujian province is relatively high.It is necessary to improve the service quality of MMT,strengthen morphine urine test during treatment,pay attention to the positive urine test.Communication and coordination with family and friends should also be strengthened to reduce the number of patients living alone and reduce dropout rate.