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Predictors of Early Dropout in Methadone Maintenance Treatment Program in Yunnan Province, China

NCJ Number
Drug and Alcohol Review Volume: 29 Issue: 3 Dated: May 2010 Pages: 263-270
Yanhua Che; Sawitri Assanangkornchai; Edward McNeil; Virasakdi Chongsuvivatwong; Jianhua Li; Alan Geater; Jing You
Date Published
May 2010
8 pages
The aim of this study is to identify the predictors of early dropout of patients in methadone maintenance treatment (MMT) clinics in Yunnan province, China.
Cumulative probability of retention at 1, 3 and 6 months was 94 percent and 57 percent, respectively. There was no relationship between dose and probability of dropout in periods 1 and 2. However, after 3 months higher average daily dose (greater than 60 mg) was associated with lower probability of dropout. Dropout was more likely among the Han ethnic group [hazard ratio (HR) = 1.86, 95 percent confidence interval (CI): 1.65-3.26], in those who had to spend over 30 min to visit the clinic (HR = 1.63, 95 percent CI: 1.07-2.49) and in those living with other drug users (HR = 2.71, 95 percent CI: 1.55-4.74). Patients' early dropout was related to ethnicity, clinic accessibility, living with drug users and methadone dose. A higher methadone dose as appropriate for maintenance treatment is recommended. A cohort study was conducted on 218 patients starting treatment in five MMT clinics between 1 March 2008 and 31 August, with follow up to 28 February 2009. Patients were interviewed using a semistructured questionnaire covering socio-demographic characteristics and drug abuse history. Attendance at clinic and daily dose were abstracted from the clinic records. The mean average daily dose per patient in each period was compared across three periods, 0-1, more than 1-3 and more than 3-6 months, using analysis of variance and random-intercept mixed linear regression modelling. Cox regression model with time-varying average daily dose within each period was performed to identify factors predicting dropout in the MMT program. (Published Abstract)