Methadone Maintenance Treatment in the Swiss Canton of Vaud: Demographic and Clinical Data on 1,782 Ambulatory Patients

Pelet, Anne; Doll, Sébastien; Huissoud, Thérèse; Resplendino, J; Besson, Jacques; Favrat, Bernard

doi:10.1159/000083039

Cited by 6 publications

(10 citation statements)

References 46 publications

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“…Twelve studies addressed the prevention of infectious diseases, especially influenza by providing vaccinations [11][12][13][14][15][16][17][18][19][20][21][22] or by performing a specific diagnostic test. 22 For clinical topics, most prevention activities addressed cardiovascular disease prevention, [23][24][25][26][27][28][29][30] cancer screening, [31][32][33][34] HIV, [35][36][37] prevention of osteoporosis, 38,39 addiction prevention, 40,41 and others [42][43][44][45][46][47] (Table 2). The most common observed intervention was counseling on lifestyle changes with twelve studies.…”

Section: Description Of Studiesmentioning

confidence: 99%

“…12 The most frequently cited barriers were "lack of knowledge/skills" (20 out of 39), 16,24,25,[30][31][32][33]35,[40][41][42][43][44]46,47,49,51,52,58,59 "lack of time/ high workload" (11 out of 39) 12,29,30,32,33,43,48,51,53,55,59 and "own disbeliefs" (9 out of 39). 17,19,25,30,[39][40][41]50,57 Lack of knowledge/skills Lack of knowledge or skills was the most common reported barrier and mentioned in studies with completely different clinical targets, eg, in studies addressing cardiovascular risk factors, 24,25,30 cancer prevention, 31,33 addiction prevention 40,41 or in different prevention interventions for infectious diseases. 16,…”

Section: Barriers From Gp's Perspectivementioning

confidence: 99%

“…This includes reluctance to use tests, eg, a detection-test of alcoholism; 41 ambivalence about the use of methadone in patients with drug use disorders; 40 disbeliefs in the quality of interventions; 17 or in their necessity; 25,30 or skepticism about current guidelines. …”

Section: Own Disbeliefsmentioning

confidence: 99%

“…[11][12][13]15,[19][20][21][22][23][24][25][26][27][28][29][30][31][33][34][35][36][37][39][40][41][42][43][44][45][46][47][48][50][51][52][53][54][55][56][57][58][59] Most frequently cited facilitators were "counselling" (15 out of 43), 12,19,20,31,33,36,37,39,41,43,44...…”

Section: Facilitators From Gp's Perspectivementioning

confidence: 99%

“…11,13,14,16,18,24,28,29,32,34,37,38,40,43,48,[50][51][52][53][54][55][56][57][58] The most frequently cited facilitators were " education/ knowledge" (8 out of 23), 11,14,16,22,24,32,50,54,55 " conviction/ motivation/ information" (5 out of 23) 28,34,43,48,50,51 and " feasibility/usefulness" (4 out of 23). 11,13,38,53 Counselling Information and GP's advice to use screening and preventive services are supporting factors.…”

Section: Facilitators From Patient's Perspectivementioning

confidence: 99%

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Screening and prevention in Swiss primary care: a systematic review

Eisner

Zoller²,

Rosemann³

et al. 2011

IJGM

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Background and objectives Prevention is a challenging area of primary care. In Switzerland, little is known about attitudes to and performance of screening and prevention services in general practice. To implement prevention services in primary care it is important to know about not only potential facilitators but also barriers. Primary care encompasses the activities of general practitioners, including those with particular interest and/or specializations (eg, pediatrics, gynecology). The aim of this study was to review all studies with a focus on prevention services which have been conducted in Switzerland and to reveal barriers and facilitators for physicians to participate in any preventive measures. Methods The Cochrane Library, PubMed, EMBASE and BIOSIS were searched from January 1990 through December 2010. Studies focussing on preventive activities in primary care settings were selected and reviewed. The methodological quality of the identified studies was classified according to the guidelines in the Consolidated Standards of Reporting Trials (CONSORT) statement. Results We identified 49 studies including 45 descriptive studies and four randomised controlled trials (RCTs). Twelve studies addressed the prevention of epidemics, eleven out of them vaccinations. Further studies focused on lifestyle changes, physical activity counselling, smoking cessation, cardiovascular prevention and cancer screening. Perceived lack of knowledge/training and lack of time were the most commonly stated barriers. Motivation, feasibility and efficiency were the most frequently reported supporting factors for preventive activities. The methodological quality was weak, only one out of four RCTs met the applied quality criteria. Conclusion Most studies focussing on screening and prevention activities in primary care addressed vaccination, lifestyle modification or cardiovascular disease prevention. Identified barriers and facilitators indicate a need for primary-care-adapted education and training which are easy to handle, time-saving and reflect the specific needs of general practitioners. If new prevention programs are to be implemented in general practices, RCTs of high methodological quality are needed to assess their impact.

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Section: Description Of Studiesmentioning

confidence: 99%

Section: Barriers From Gp's Perspectivementioning

confidence: 99%

Section: Own Disbeliefsmentioning

confidence: 99%

Section: Facilitators From Gp's Perspectivementioning

confidence: 99%

Section: Facilitators From Patient's Perspectivementioning

confidence: 99%

See 3 more Smart Citations

Screening and prevention in Swiss primary care: a systematic review

Eisner

Zoller²,

Rosemann³

et al. 2011

IJGM

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Methadone Maintenance Treatment (MMT) in General Practice or in Specialized Centers: Profile of Patients in the Swiss Canton of Vaud

Pelet¹,

Doll²,

Huissoud

et al. 2007

The American Journal of Drug and Alcohol Abuse

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We studied profile of patients (n=1782) treated in specialized centers and general practice (GP) enrolled in methadone maintenance treatment (MMT) programs during 2001 in the Swiss Canton of Vaud. We found that GPs treated the majority of patients (76%). Specialized centers treated a higher proportion of patients with uncontrolled intravenous use of cocaine and heroin, and prescribed neuroleptics as concomitant medication three times more frequently than GPs. Patients treated in specialized centers were more likely to undergo screening for HIV, HBV, HCV, and receive complete HBV immunization. In conclusion, specialized centers are more likely to treat severely addicted patients and patients with a poor global assessment (physical, psychiatric, and social).

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Determinants of successful chronic hepatitis C case finding among patients receiving opioid maintenance treatment in a primary care setting

2009

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Aims Injection drug users are at high risk for chronic hepatitis C virus infection (CHC). Opioid maintenance treatment (OMT) offers a unique opportunity to screen for CHC. This study proposed the hypothesis that a general practitioner (GP) with special interest in addiction medicine can achieve CHC screening rates comparable to specialized centres and aimed to investigate determinants for a successful CHC case finding in a primary care setting.Design and participants Retrospective medical record analysis of 387 patients who received opioid maintenance therapy between 1 January 2002 and 31 May 2008 in a general practice in Zurich, Switzerland.Measurements Successful CHC assessment was defined as performance of hepatitis C virus (HCV) serology with consecutive polymerase chain reaction‐based RNA and genotype recordings. The association between screening success and patient characteristics was assessed using multiple logistic regression.Findings Median (interquartile range) age and duration of OMT of the 387 (268 males) patients was 38.5 (33.6–44.5) years and 34 (11.3–68.0) months, respectively. Fourteen patients (3.6%) denied HCV testing and informed consent about screening was missing in 13 patients (3.4%). In 327 of 360 patients (90.8%) with informed consent a successful CHC assessment has been performed. Screening for HCV antibodies was positive in 136 cases (41.6%) and in 86 of them (63.2%) a CHC was present. The duration of OMT was an independent determinant of a successful CHC assessment.Conclusions In addicted patients a high CHC assessment rate in a primary care setting in Switzerland is feasible and opioid substitution provides an optimal framework.

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Methadone Maintenance Treatment in the Swiss Canton of Vaud: Demographic and Clinical Data on 1,782 Ambulatory Patients

Cited by 6 publications

References 46 publications

Screening and prevention in Swiss primary care: a systematic review

Screening and prevention in Swiss primary care: a systematic review

Methadone Maintenance Treatment (MMT) in General Practice or in Specialized Centers: Profile of Patients in the Swiss Canton of Vaud

Determinants of successful chronic hepatitis C case finding among patients receiving opioid maintenance treatment in a primary care setting

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