title: Misconceptions predict dropout and poor adherence prospectively among newly admitted first-time methadone maintenance treatment clients in Guangzhou, China.
abstract: OBJECTIVE
  To investigate the incidence of dropout and the prevalence of poor adherence among newly admitted first-time clients of methadone maintenance treatment (MMT) clinics, and the associations between MMT-related misconceptions and these two treatment outcomes.
  
  
  METHODS
  A cohort study (maximum follow-up period = 17.6 months) was conducted.
  
  
  METHODS
  Three of the nine MMT clinics in Guangzhou, China participated in the study.
  
  
  METHODS
  The sample included 158 newly admitted first-time MMT clients.
  
  
  METHODS
  Information collected included background characteristics, history of drug use, MMT-related misconceptions, dropout during the entire study period and poor adherence within the first 6 months since admission to MMT.
  
  
  RESULTS
  Of all newly admitted MMT clients, 98.2% possessed at least one and 50.6% possessed all four types of MMT-related misconception; 51.3% had dropped out before the completion of the study [95% confidence interval (CI): 43.5-59.1%] and 62% exhibited poor adherence within the first 6 months since admission (95% CI: 54.2-69.6%). Adjusting for significant background variables, the number of misconceived responses predicted significantly both dropout [hazard ratio (HR) = 3.80 for two to three misconceived items, HR = 7.13 for four misconceived items, with zero to one misconceived item being the reference] and poor adherence within the first 6 months [relative risk (RR) = 4.13 for two to three misconceived items; RR = 4.40 for four misconceived items, with zero to one misconceived item being the reference.
  
  
  CONCLUSIONS
  Among opiate addicts in China prescribed methadone maintenance therapy for the first time, misconceptions about this medication are prevalent and are associated with poor adherence to the medication regimen and a high a rate of dropout from the treatment programme.
authors.affiliation: School of Public Health, Sun Yat-sen University, Guangzhou, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Gu
authors.forename: Huifang
authors.initials: H
authors.lastname: Xu
authors.forename: Joseph T F
authors.initials: JT
authors.lastname: Lau
authors.forename: Yuantao
authors.initials: Y
authors.lastname: Hao
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhong
authors.forename: Lirui
authors.initials: L
authors.lastname: Fan
authors.forename: Yuteng
authors.initials: Y
authors.lastname: Zhao
authors.forename: Chun
authors.initials: C
authors.lastname: Hao
authors.forename: Wenhua
authors.initials: W
authors.lastname: Ling
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use*; D058850:Opiate Substitution Treatment / Q000523:psychology*; D009293:Opioid-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation*; D010352:Patient Dropouts / Q000523:psychology / Q000706:statistics & numerical data; D011446:Prospective Studies; D055990:Therapeutic Misconception / Q000523:psychology*; D016903:Drug Monitoring
chemical_list: D009294:Narcotics; D008691:Methadone