Abstract
Methadone maintenance treatment (MMT) requires patients to intake their daily dose in person at their clinic. Therefore, transfer services are vital for patients who need temporary leave from their primary MMT clinic. However, studies have shown that transfer patients might delay return after temporary leave, leading to missed doses and putting them at risk of increased harm. In this study, we aimed to explore the transfer rates and factors associated with MMT patients who delayed return during a transfer period. In this retrospective analysis, we used audit records from the web-based management system from six MMT clinics in Guangdong, China. Multilevel logistic regression and multilevel Poisson regression analyses were used to examine the factors associated with patients who delayed return to their primary MMT clinic. A total of 459 people used the transfer system 2940 times between January 2006 and December 2016. Of those, patients delayed return to their primary MMT clinic 1199 times (40.78%). Patients who transferred regularly had poor compliance rates with MMT treatment. Those who once dropped out from and then re-enrolled in MMT were more likely to delay return. Most patients (82.71%) who used the transfer service for “work” were more likely to prolong their delay length. The findings highlight that a more flexible transfer system would minimize inconvenience to the patients.
Highlights
Opioid dependence is a chronic health condition that necessitates long-term treatment [1,2].Methadone maintenance treatment (MMT) is regarded by the Word Health Organization (WHO, 2009)as the most effective substitute therapy for opioid addiction
Our research suggests that patients with a poor compliance history might be involved in a cyclical problem exacerbated by the administration system
Our research provides a reference for establishing a cross-regional system for MMT clinic transfer patients
Summary
Opioid dependence is a chronic health condition that necessitates long-term treatment [1,2].Methadone maintenance treatment (MMT) is regarded by the Word Health Organization (WHO, 2009)as the most effective substitute therapy for opioid addiction. Opioid dependence is a chronic health condition that necessitates long-term treatment [1,2]. Methadone maintenance treatment (MMT) is regarded by the Word Health Organization (WHO, 2009). With long-term treatment, the social functioning of MMT patients improves greatly [4]. Take-home doses and transfer services are the most prevalent solutions worldwide. In Singapore, MMT clinics provide take-home doses for the patients who are unable to attend the clinic every day [7]. The take-home doses are not available for all patients in the clinic [8]. Take-home doses are a privilege and are only provided to those patients who (1) have fully cooperated with the treatment, and (2) have a minimum of three months with no positive
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