The analysis of influence factors of transfer patients who had increased methadone dosage after missed doses in transfer services utilization / 中华疾病控制杂志

ABSTRACT

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%CI1.85-4.50, 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%CI0.95-0.99, 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.