title: Predictors of retention in methadone programs: a signal detection analysis.
abstract: Retention in Opioid Agonist Therapy (OAT) is associated with reductions in substance use, HIV risk behavior, and criminal activities in opioid dependent patients. To improve the effectiveness of treatment for opioid dependence, it is important to identify predisposing characteristics and provider-related variables that predict retention in OAT. Participants include 258 veterans enrolled in 8 outpatient methadone/l-alpha-acetylmethadol (LAAM) treatment programs. Signal detection analysis was utilized to identify variables predictive of 1-year retention and to identify the optimal cut-offs for significant predictors. Provider-related variables play a vital role in predicting retention in OAT programs, as higher methadone dose (> or =59 mg/day) and greater treatment satisfaction were among the strongest predictors of retention at 1-year follow-up.
authors.affiliation: Center for Health Care Evaluation, Veterans Affairs Palo Alto Health Care System & Stanford University School of Medicine, CA, USA. Steven.Villafranca@va.gov
authors.forename: Steven W
authors.initials: SW
authors.lastname: Villafranca
authors.forename: John D
authors.initials: JD
authors.lastname: McKellar
authors.forename: Jodie A
authors.initials: JA
authors.lastname: Trafton
authors.forename: Keith
authors.initials: K
authors.lastname: Humphreys
mesh_terms: D000328:Adult; D002140:California; D003131:Combined Modality Therapy / Q000523:psychology / Q000706:statistics & numerical data; D015897:Comorbidity; D003376:Counseling; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000517:prevention & control / Q000523:psychology; D006302:Health Services Research / Q000706:statistics & numerical data; D006556:Heroin Dependence / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008692:Methadyl Acetate / Q000627:therapeutic use*; D008875:Middle Aged; D009294:Narcotics / Q000819:agonists* / Q000627:therapeutic use*; D010352:Patient Dropouts / Q000523:psychology / Q000706:statistics & numerical data*; D017060:Patient Satisfaction; D012309:Risk-Taking; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data*
chemical_list: D013287:Illicit Drugs; D009294:Narcotics; D008692:Methadyl Acetate; D008691:Methadone