Predictors of retention in community-based methadone maintenance treatment program in Pearl River Delta, China

Fang Yang,Yulan Luo,Yan Li,Qisui Long,Qun He,Peng Lin,Xiaobing Fu

doi:10.1186/1477-7517-10-3

Abstract

BackgroundThe aims were to identify predictors of treatment retention in methadone maintenance treatment (MMT) clinics in Pearl River Delta, China.MethodsRetrospective longitudinal study. Participants: 6 MMT clinics in rural and urban area were selected. Statistical analysis: Stratified random sampling was employed, and the data were analyzed using Kaplan-Meier survival curves and life table method. Protective or risk factors were explored using Cox’s proportional hazards model. Independent variables were enrolled in univariate analysis and among which significant variables were analyzed by multivariate analysis.ResultsA total of 2728 patients were enrolled. The median of the retention duration was 13.63 months, and the cumulative retention rates at 1,2,3 years were 53.0%, 35.0%, 20.0%, respectively. Multivariate Cox analysis showed: age, relationship with family, live on support from family or friends, income, considering treatment cost suitable, considering treatment open time suitable, addiction severity (daily expense for drug), communication with former drug taking peer, living in rural area, daily treatment dosage, sharing needles, re-admission and history of being arrested were predictors for MMT retention.ConclusionsMMT retention rate in Guangdong was low and treatment skills and quality should be improved. Meanwhile, participation of family and society should be encouraged.

Highlights

The aims were to identify predictors of treatment retention in methadone maintenance treatment (MMT) clinics in Pearl River Delta, China
According to the Chinese Implementation Protocol for Community-Based Methadone Maintenance Treatment for Opiate Addicts, the eligibility criteria to participate in MMT were: (i) clients who are addicted to opiate according to addiction protocol; (ii) at least 20 years of age; (iii) the number of allowable missing treatment days was 7 consecutive days; and (iv) capable of complete civil liability
There were a total of 56 MMT clinics in Guangdong until September 30th in 2010, among which 31 clinics were located in Pearl River Delta region, 17 clinics in urban area and 14 clinics in rural area

Summary

Introduction

The aims were to identify predictors of treatment retention in methadone maintenance treatment (MMT) clinics in Pearl River Delta, China. International evidence-based practices have proved that Methadone maintenance treatments (MMTs) are effective to reduce heroin use and high-risk behaviors, as well as to prevent transmission of HIV and HCV [1,2,3,4]. In consideration of epidemic of HIV among drug users, China initiated MMT in Yunnan, Sicuan, Zhejiang, Guizhou and Guangxi provinces in 2004 with 8 MMT clinics established .With the success of the pilot MMT clinics, 680 MMT clinics were established by the end of 2009 nationwide, 241975 patients were recruited accumulatively, and the retention rate was 65%. According to the Chinese Implementation Protocol for Community-Based Methadone Maintenance Treatment for Opiate Addicts, the eligibility criteria to participate in MMT were: (i) clients who are addicted to opiate according to addiction protocol; (ii) at least 20 years of age; (iii) the number of allowable missing treatment days was 7 consecutive days; and (iv) capable of complete civil liability

Objectives

Methods

Results

Discussion

Conclusion