Factors Associated with Methadone Treatment Duration: A Cox Regression Analysis

Abstract

This study examined retention rates and associated predictors of methadone maintenance treatment (MMT) duration among 128 newly admitted patients in Taiwan. A semi-structured questionnaire was used to obtain demographic and drug use history. Daily records of methadone taken and test results for HIV, HCV, and morphine toxicology were taken from a computerized medical registry. Cox regression analyses were performed to examine factors associated with MMT duration. MMT retention rates were 80.5%, 68.8%, 53.9%, and 41.4% for 3, 6, 12, and 18 months, respectively. Excluding 38 patients incarcerated during the study period, retention rates were 81.1%, 73.3%, 61.1%, and 48.9% for 3 months, 6 months, 12 months, and 18 months, respectively. No participant seroconverted to HIV and 1 died during the 18-months follow-up. Results showed that being female, imprisonment, a longer distance from house to clinic, having a lower methadone dose after 30 days, being HCV positive, and in the New Taipei city program predicted early patient dropout. The findings suggest favorable MMT outcomes of HIV seroincidence and mortality. Results indicate that the need to minimize travel distance and to provide programs that meet women’s requirements justify expansion of MMT clinics in Taiwan.

Retention of patients in opioid substitution treatment: A systematic review

“…The most frequently used measure of dropout was time to discontinuation of OST (n = 32), with varying thresholds applied to identify date of dropout. Almost half the studies reporting on time to discontinuation did not specify a threshold for identifying dropout (n = 13) [37,40,42,43,45,56,62,65,68,69,85,91,94]; seven studies indicated that a patient was identified as having dropped out of OST if they missed more than 30 consecutive days of treatment [53,57,60,67,74,80,92]; six studies applied a threshold of seven days [44,46,49,78,96,97], and the remaining studies applied a threshold of five days [83], ten days [51], 14 days [58,66,95], 21 days [63]and two months [59]. The other six studies reporting on dropout used a binary measure, which identified patients as having dropped out of treatment after a specific period of follow-up [38,48,55,61,79,88].…”

The Association between Living Status Transitions, Behavior Changes and Family Relationship Improvement among Methadone Maintenance Treatment Participants in Guangdong, China

“…(2) had baseline information; (3) had at least one follow-up record before their first dropout (failing to take methadone for 14 consecutive days or more was considered as a dropout [35][36][37]).…”

Re-entry and related predictors among HIV-infected clients receiving methadone maintenance treatment in Guangdong province, China

“…In this study, "drop-out" was defined as a participant failing to continue MMT for 14 consecutive days (21,22), and the drop-outs included "loss-to-followup" and "re-entry". Those drop-outs who did not return by the end of the study were classified into the "lossto-follow-up" group, while those who returned at least once by the end of the study were classified into the "re-entry" group.…”

“…So far, retention has proven to be a valuable indicator of MMT effectiveness (21). High drop-out means many clients terminated the treatment before obtaining therapeutic benefits.…”