云南省德宏州两县美沙酮维持治疗门诊和延伸服药点服务现况

Current situation of standard methadone maintenance treatment clinics and extension clinics in Dehong prefecture, Yunnan province

目的了解美沙酮维持治疗(MMT)门诊和延伸服药点的服务现状。方法在云南省德宏州陇川县和盈江县的2家MMT门诊和5家延伸服药点,对MMT≥5个月的服药人员进行现况调查,利用问卷收集服药人员的人口学特征、MMT情况、满意情况等信息,采用卡方检验比较分析延伸服药点和MMT门诊的服务现状差异。结果研究对象共509人,其中MMT门诊236人,年龄41.8(35.6～51.0岁)岁;延伸服药点273人,年龄43.6(37.8～52.4岁)岁。MMT门诊的服药依从率95.8%,低剂量(<60mg/天)服药率62.7%,尿检阳性率21.8%,延伸服药点分别为89.7%、50.5%、4.9%。MMT门诊的总体满意率为94.0%,延伸服药点为87.8%。卡方检验显示,MMT门诊和延伸服药点的服药依从率、尿检阳性率、总体满意率差异均具有统计学意义(P<0.05)。结论延伸服药点一定程度上满足了偏远地区阿片成瘾者服用美沙酮的需求,但是存在不足,应加强延伸服药点的管理和建设,进一步提升延伸服药点的工作能力。

Objective To know the current situation of standard methadone maintenance treatment(MMT)clinics and extension MMT clinics.Methods The survey was conducted in 2 standard MMT clinics and 5 extension clinics located in Longchuan county and Yingjiang county of Dehong prefecture,Yunnan province.Clients in MMT at least 5 months were interviewed and questionnaire was used to collect information about their demographic characteristics,MMT characteristics and satisfaction with MMT services.Chi-square test was used to compare service differences between standard MMT clinics and extension clinics.Results A total of 509 clients were recruited,236 clients from standard MMT clinics and 273 clients from extension clinics.In standard MMT clinics,the median age of clients was 41.8(35.6-51.0)years,and in extension clinics,43.6(37.8-52.4)years.The proportion of good treatment adherence was 95.8%,with 62.7%of lower daily methadone dosage(<60 mg/d),21.8%of positive urine-morphine testing,and 94.0%of satisfaction in standard MMT clinics;and 89.7%,50.5%,4.9%,and 87.8%in extension clinics correspondingly.Chi-square test showed that there were differences in compliance rate,positive urine-morphine testing rate,and satisfaction rate between two types of clinics(P<0.05).Conclusion The extension clinic is effective in providing MMT services in remote areas.But there are still some deficiencies and the capacity needs to be strengthened.