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Objective To investigate the effect of transfer service utilization in increased methadone dosage after missed dose of participants in methadone maintenance treatment (MMT).Methods We selected 9 MMT clinics in Guangdong Province and collected the data from the web-based system of MMT management. All the participants who had utilized the transfer service from January 2008 to December 2016 were included in our study. We explored multilevel Logistic regression analysis to explore the associated factors of changing methadone dosage after missed dosage of transfer participants.Results A total of 197 patients were included in the study for a total of 840 person-time transfer services. Of these, 119 (14.26%) had increased-dose after transfer. The patients whose (1) dose of methadone was less than 60 ml/d during the transfer period (OR=2.88, 95%CI:1.85-4.50, P<0.001), (2)had longer transfer period (OR=1.02, 95%CI: 1.01-1.03, P<0.001), and (3) fewer cumulative transfertimes (OR=0.97, 95%CI:0.95-0.99, P=0.004) were more likely to increase the methadone dosage after the missed.Conclusions The characteristic of transfer service utilization could result in the increasing methadone dosage after missed doses in transfer participants. This finding suggest MMT clinic should strengthen the supervision of transfer patients, especially those who failed to return on time after transfer. The doctors in MMT should carefully consider the dose adjustment requirements from patients and improve the efficacy of methadone maintenance treatment.
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Background. Non-adherence to specific allergen immunotherapy is a major hurdle faced by the allergist, contributing to poor clinical outcomes. Objectives. To assess the independent association of various factors with non-adherence to specific allergen immunotherapy. Methods. Fifty consecutive (non-adherent) and control (adherent) subjects receiving specific allergen immunotherapy were included in the study and various factors related to non-adherence including socio-demographic, clinical and immunotherapy related variables were compared between the two groups by univariate and multivariate analysis. Results. On univariate analysis, gender, allergic conjunctivitis, family history, progression of disease, perception of immunotherapy, medicine requirement, and the pattern of missed doses greater than two in the last 10, 20 and 30 doses were found to be significantly associated with non-adherence. On multivariate analysis, independent association was observed with allergic conjunctivitis, family history, perception of immunotherapy, missed doses greater than two in the last 10 doses of immunotherapy and medicine requirement. Conclusions. The independent factors associated with non-adherence may vary between different settings and countries. There is a need for developing individual case holding programmes to improve clinical outcomes in patients receiving specific allergen immunotherapy.