The Investigation Of Operation Status Quo And Related Factors Of Clinics Methadone Maintenance Treatment In Hubei Province

Objective:To explore operation status and influencing factor of Methadone Maintenance Treatment (MMT) in clinics,a survey was carried out in Hubei Province to look for baseline data for further scientific targeted interventions by investigating and analyzing the population of MMT, dropout rate, MMT clinics’ operational difficulties, staff cognition, target population medication compliance and related factors.Methods:Through census and multistage sampling method,48MMT clinics,101staffs (include doctors, pharmacists and nurses) and359cases of MMT patients were chosen for this research in Hubei Province. With self-designed questionnaire "MMT clinic operation situation table" and "MMT clinic interview table", the status quo and influencing factors about dropout rate, operation difficulties etc. were surveyed. With "MMT staff awareness to reduce the harm of drugs questionnaire", the cognition and related factors about MMT staff was investigated. With self-designed "MMT patients’ basic condition questionnaire","Mosiky medication compliance scale", and "social support scale"(SSRS, by Xiao Shui yuan), the patients’compliance to MMT, social support and the possible influencing factors were surveyed.Results:There were6900patients in treatment in48MMT clinics. The overall dropout rate was20.40%and4clinics’dropout rates were more than45.00%. The factors influencing dropout included patient criminal detainees (84.09%), having drugs again (75.00%) and the patient referral (56.82%). The awareness rates of101cases of MMT clinic staff about "taboo of MMT ","pharmacological effects of MMT" and "drug harm reducing effect of MMT" were97.03%,77.23%、77.23%respectively. The awareness rates of MMT clinic staff about "patients’conditions of accepting MMT" and "the base of MMT therapeutic doses" were41.58%and26.73%. The higher administrative level the staff belonged to, the higher cognitive rate of MMT they had (P<0.05). Among359cases of MMT patients,183cases (50.98%) had good compliance,144cases (40.11%) medium compliance and32patients (8.91%) had poor compliance. Logistic regression analysis showed, female patient, low craving for drugs, believing in good treatment effect of MMT and satisfying with clinic serve were the promoting factors of compliance (P<0.05). To359Cases of MMT patients, the total score of social support was31.14±9.022; among which subjective support points was19.47±6.265; objective support score6.43±2.807; and5.24±2.084belonged to utilization of support. In addition to this, Logistic regression analysis also showed that, for MMT patients, heterosexual couples, harmony family and opposition to have drug in treatment might be social support promoting factors (P<0.05).Conclusions:MMT in clinics had a high dropout rate in Hubei Province. Main influencing factors of this phenomenon were the patient criminal detainees and having drug and that clinic staffs’ low level cognition of MMT knowledge might have influence. Comprehensive intervention of government-led, multisectoral collaboration, professional organizations advocating and patients’ participating should be strengthened to improve the MMT social supporting and patients’ compliance.