title: Predictors of methadone program non-retention for opioid analgesic dependent patients.
abstract: This study evaluates loss to follow-up in a methadone maintenance treatment (MMT) program for patients dependent on opioid analgesics in a community in eastern Canada. Data were collected using the Addiction Severity Index Lite. The probability of loss to follow-up was evaluated using a time-to-event analysis. Involuntary and voluntary program discharges were treated separately as the outcomes of interest. Multivariate Cox proportional hazards models were used to explore the role of various patient-related attributes. The probabilities of involuntary and voluntary discharges at 1 year were 20% and 14%, respectively. In this exploratory analysis, determinants of loss to follow-up were characteristics related to drug use history (e.g., use of sedatives) and its consequences (e.g., number of lifetime arrests), and differed for each outcome. Some determinants of involuntary discharge were modified by sex. Understanding predictors of specific loss to follow-up outcomes may help MMT programs improve patient retention.
authors.affiliation: Mental Health and Addiction Services, Cape Breton District Health Authority, Sydney, Nova Scotia, Canada B1P 1P3. jcox@santepub-mtl.qc.ca
authors.forename: Joseph
authors.initials: J
authors.lastname: Cox
authors.forename: Robert
authors.initials: R
authors.lastname: Allard
authors.forename: Emilie
authors.initials: E
authors.lastname: Maurais
authors.forename: Noreen
authors.initials: N
authors.lastname: Haley
authors.forename: Chris
authors.initials: C
authors.lastname: Small
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects*; D002170:Canada; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008691:Methadone / Q000008:administration & dosage*; D015999:Multivariate Analysis; D058850:Opiate Substitution Treatment / Q000379:methods*; D009293:Opioid-Related Disorders / Q000534:rehabilitation*; D010349:Patient Compliance; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D000701:Analgesics, Opioid; D008691:Methadone