Predictors of patient retention in a newly established methadone maintenance treatment programme.
OBJECTIVE
To identify predictors of patient retention in methadone maintenance.


METHODS
Prospective study.


METHODS
Methadone maintenance treatment programme newly established in Geneva, Switzerland.


METHODS
All patients who initiated treatment between February 1991 and January 1995.


METHODS
Baseline patient characteristics, dose of methadone, year of enrollment and retention in treatment.


RESULTS
Overall, 111 patients contributed 164.4 person-years of follow-up. The retention rate was 84% after 12 months. In multivariate analysis, the risk of dropping out was significantly higher for patients who had been using opioids for < or = 7 years (relative hazard (RH) 3.0, 95% confidence interval (CI) 1.2-7.4), and for patients who had no stable income at baseline (RH 3.3, 95% CI 1.2-9.1). Dropouts were less frequent at the highest doses of methadone (65-110 mg/day, RH 1.0) than at middle doses (45-60 mg/day, RH 2.0, 95% CI 0.7-5.5) but, quite unexpectedly, dropouts were least likely at the lowest doses (15-40 mg/day, RH 0.5, 95% CI 0.1-1.8). Dropouts were more likely among patients who enrolled in the first (RH 6.2, 95% CI 2.3-16.7) and second (RH 1.9, 95% CI 0.6-5.6) years of the programme, compared with subsequent years (RH 1.0).


CONCLUSIONS
Patients who have a long history of drug use and who have a stable income were more likely to stay in methadone maintenance treatment. Independent of patient characteristics, retention improved dramatically in the first years of programme functioning, suggesting that patient retention is a sensitive indicator of programme performance.
del Rio
M
M
Department of Psychiatry, Geneva University Hospitals, Switzerland.
Mino
A
A
Perneger
T V
TV
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D009294:Narcotics / Q000627:therapeutic use*; D010352:Patient Dropouts; D011379:Prognosis; D015397:Program Evaluation; D011446:Prospective Studies; D019966:Substance-Related Disorders / Q000534:rehabilitation*
D009294:Narcotics; D008691:Methadone