A Study Of The Effects Of Practicing A Reasonable High Dosage Methadone Maintenance Treatment Program On Patient’s Retention Rate

Objectives：1. To evaluate the effect of providing enhancing methadone dosage relatedtraining for methadone maintenance treatment (MMT) medical staff on methadonedosage.2.To evaluate the effect of promotion of the reasonable high dose methadoneintervention on retention time and the retention rate of MMT patients.Methods：Prospective community-based clinical trial was conducted in this study. MMTclinics were selected and were classified into intervention group and control group.Training on promoting reasonably high doses of methadone were provided for MMTclinic doctors in the intervention group and the effects on methadone dosage andretention were evaluated. The trainings were conducted in February,2012February.New MMT entrants of patients during March1,2012to September1,2012wererecruited and followed up for6months for the effect evaluation.The treatment information on MMT entrants of patients during September,2011to March,2012were collected retrospectively. The data before the promotion of thereasonable high dose methadone intervention were used to analyze the dosage and theretention rate before the promotion program and to explore the risk factors, and werefurther used to study the effects of the promotion program.Results：1. The analysis of Non-conditional logistic regression model showed that thefollowing factors were associated with high MMT dosage: education level of highschool or above versus primary school or below (OR=1.952,95%CI:1.087~3.503).Non-injection drug use (OR=2.425,95%CI:1.388~4.239), and history of detoxification(OR=0.417,95%CI:0.191,0.913).2. The analysis of multiple Cox proportional hazard regression model showed thefollowing factors were associated with drop-out: the age group of40-49years old versus the18~29group（RR=0.510,95%CI:0.330~0.788), age group over50yearsold(RR=0.417,95%CI:0.191~0.913).3.The mean daily dosage of MMT patient in control group and interventiongroup were55.15±23.15mg/d, and58.80±26.01mg/d, respectively. There was nostatistically significant difference.4.Within6months fellow up, the mean retention time and6months’ retentionrate in control group were4.51±0.14months and57.9%, respectively. While those inintervention group were4.60±0.09months and61.0%, respectively. There was nosignificant difference between two groups by log-rank test-(χ2=0.409，p=0.522).Conclusions：1. Training MMT clinic doctor to enhance methadone dosage was ineffective ondosage increase in this study.2. There is no significant difference between intervention group and controlgroup in terms of maintenance time and maintenance rate, which indicated that theintensive training for MMT doctors did not produce desired effect in a short period.3. At present MMT is still in the exploratory stage in our country. As thedifference of knowledge background of medical staff, and the effect of the patient’sinclination on the MMT treatment dose training MMT doctor for a short-term toimprove patient’s retention rate was difficult.