2016年云南省德宏州美沙酮维持治疗者服药依从性影响因素

详细信息    查看全文 | 推荐本文 |

英文篇名：Associated factors affecting compliance amongmethadone maintenance treatment clients in Dehong prefecture of Yunnan province in 2016 作者：唐仁海 ; 吴婧 ; 叶润华 ; 杨跃诚 ; 姚仕堂 ; 王继宝 ; 李林 ; 官平珍 ; 赵乙澳 ; 杨光文 ; 龙玉存 ; 尹棉松 ; 何纳 ; 段松 英文作者：TANG Renhai;WU Jing;YE Runhua;YANG Yuecheng;YAO Shitang;WANG Jibao;LI Lin;GUAN Pingzhen;ZHAO Yiao;YANG Guangwen;LONG Yucun;YING Miansong;HE Na;DUAN Song;Dehong Prefecture Center for Disease Control and Prevention;School of Public Health, Anhui Medical University;Mangshi County Center for Disease Control and Prevention;Yingjiang County Center for Disease Control and Prevention;Ruili County Center for Disease Control and Prevention;Longchuan County Center for Disease Control and Prevention;Lianghe County Center for Disease Control and Prevention;Department of Epidemiology, School of Public Health, Fudan University; 关键词：美沙酮维持治疗 ; 依从性 ; 影响因素 ; Logistic回归分析 英文关键词：Methadone maintenance treatment;;Compliance;;Associated factors;;Logistic regression analysis 中文刊名：XBYA 英文刊名：Chinese Journal of AIDS & STD 机构：德宏州疾病预防控制中心;安徽医科大学公共卫生学院;芒市疾病预防控制中心;盈江县疾病预防控制中心;瑞丽市疾病预防控制中心;陇川县疾病预防控制中心;梁河县疾病预防控制中心;复旦大学公共卫生学院流行病学教研室公共卫生安全教育部重点实验室; 出版日期：2019-04-26 出版单位：中国艾滋病性病 年：2019 期：v.25;No.187 基金：国家科技重大专项(2013ZX10004-906)~~ 语种：中文; 页：XBYA201904018 页数：4 CN：04 ISSN：11-4818/R 分类号：73-76

摘要

目的分析2016年云南省德宏州美沙酮维持治疗病人服药依从性及其影响因素。方法从德宏州各门诊/拓展点的"社区美沙酮维持治疗客户端"中获取相关数据。2016年1月德宏州正在接受美沙酮维持治疗者,根据当年累计服药天数是否>240天进行分组,采用Logistic回归模型探索影响美沙酮维持治疗者服药依从性的相关因素。结果共调查2 121名美沙酮维持治疗者,其中服药天数超过240天的有1 438人(67.8%)。30～50岁、>50岁者[比值比(OR):1.80、3.01,95%可信区间(CI):1.14～2.84、1.80～5.03],日均治疗剂量>65mL者(OR:1.71,95%CI:1.37～2.13)依从性较好,生活来源靠自己者(OR:0.63,95%CI:0.51～0.79),与家人的关系一般及较差者(OR:0.74,95%CI:0.60～0.92),最近一次尿检结果阳性者(OR:0.39,95%CI:0.30～0.50)依从性较差。结论德宏州美沙酮维持治疗病人服药依从性好坏与治疗者年龄、日均治疗剂量、生活来源、与家人的关系及尿检结果有关。
        Objective To analyze the compliance and its associated factors among methadone maintenance treatment(MMT) clients in Dehong prefecture in 2016. Methods Relevant data of MMT clinics were obtained from the "Community Methadone Maintenance Therapy Client" and extension MMT clinics. A total of 2 121 patients had received MMT up to January 2016. The patients were divided according to whether the annual number of medication days was more than 240 days. Logistic regression model was used to explore the associated factors affecting the compliance among MMT clients. Results A total of 2 121 MMT clients participated in the survey, with 1 438 patients(67.8%) who maintained treatment for more than 240 days. Patients with the age between 30 to 50 years and over 50 years(OR: 1.80, 3.01, 95%CI: 1.14-2.84, 1.80-5.03), the average therapeutic dose over 65 ml(OR: 1.71, 95%CI: 1.37-2.13) were likely to had a higher rate of MMT compliance. Those who lived on their own(OR: 0.63, 95% CI: 0.51-0.79), had a disharmonious relationship with the family members(OR: 0.74, 95%CI: 0.60-0.92), and had positive results of urinalysis(OR: 0.39, 95%CI: 0.30-0.50), were likely to have a lower rate of MMT compliance. Conclusion The compliance among MMT clients in Dehong prefecture is related to the age, the average therapeutic dose, the source of income, the relationship with the family members, and the results of urinalysis.

引文

[1] Joseph H,Stancliff S,Langrod J.Methadone maintenance treatment (MMT):a review of historical and clinical issues[J].Mount Sinai Journal of Medicine New York,2015,67(5-6):347.
    [2] Sullivan SG,Wu Z,Rou K,et al.Who uses methadone services in China?Monitoring the world’s largest methadone programme[J].Addiction,2015,110(Suppl.1):29-39.
    [3] 王逸超,李建华.美沙酮维持治疗依从性的研究进展[J].中国药物滥用防治杂志,2013,19(1):37-41.
    [4] Zhang Z,Friedmann PD,Gerstein DR.Does retention matter?Treatment duration and improvement in drug use[J].Addiction,2003,98(5):673-684.
    [5] 曹晓斌,吴尊友.美沙酮维持治疗预防HIV研究进展[J].中国艾滋病性病,2011,17(2):196-199.
    [6] 中国疾病预防控制中心性病艾滋病预防控制中心.2015年12月全国艾滋病性病疫情及主要防治工作进展[J].中国艾滋病性病,2016,22(2):69.
    [7] 赵余仙,朵林,阮元,等.云南省美沙酮维持治疗门诊受治者依从性影响因素分析[J].皮肤病与性病,2010,32(2):3-4.
    [8] 韦辉,李明丽,李荣健,等.广西2010—2013年美沙酮维持治疗者脱失原因及其影响因素分析[J].中华疾病控制杂志,2014,18(12):1187-1190.
    [9] 罗莉,刘普林,刘聪,等.美沙酮维持治疗病人与社区海洛因吸食者家庭环境及社会支持情况比较[J].中国艾滋病性病,2014,20(7):537-539.
    [10] 李明丽,蓝光华,李荣健,等.广西吸毒人群美沙酮维持治疗5年随访调查[J].中国公共卫生,2014,30(6):697-700.
    [11] 刘建波,地力夏提·亚合甫,李凡,等.美沙酮维持治疗保持时间及其影响因素的COX回归分析[J].中国艾滋病性病,2007,13(2):160-161.
    [12] 王君,李凡,莫兰榕,等.乌鲁木齐市吸毒者社区美沙酮维持治疗保持情况及其影响因素分析[J].中华流行病学杂志,2007,28(1):37-41.
    [13] Liu E,Liang T,Shen L,et al.Correlates of methadone client retention:a prospective cohort study in Guizhou province,China[J].International Journal of Drug Policy,2009,20(4):304-308.
    [14] Blaney T,Craig RJ.Methadone maintenance.Does dose determine differences in outcome[J].J Subst Abuse Treat,1999,16(3):221-228.
    [15] 高倩,钱兴才,丁蕾,等.美沙酮维持治疗者偷吸及保持状况调查[J].中国公共卫生,2008,24(12):1415-1416.
    [16] 唐桂华,盘尚青.美沙酮维持治疗者偷吸毒品原因调查及干预效果分析[J].应用预防医学,2016,22(1):31-33.
    [17] 赵晓芬,方永年,邢小珍.探讨综合干预对美沙酮药物维持治疗者偷吸原因的影响[J].中国药物滥用防治杂志,2010,16(2):93-96.
    [18] 陈康林,郝春,阮玉华,等.海洛因成瘾者社区美沙酮维持治疗脱失和保持的定性研究[J].中国药物滥用防治杂志,2006,12(6):315-319.
    [19] 张广,张存敏,罗健,等.美沙酮维持治疗社区拓展服药点的定性调查[J].中国艾滋病性病,2012,18(4):231-233.
    [20] 张广,杨跃诚,唐仁海,等.美沙酮维持治疗拓展服药点在治人员特征和维持治疗情况分析[J].中华预防医学杂志,2014,48(11):964-968.