title: Risk factors for fatal outcome in patients with opioid dependence treated with methadone in a family medicine setting in Croatia.
abstract: OBJECTIVE
  To determine the risk factors for fatal outcome in patients with opioid dependence treated with methadone at the primary care level.
  
  
  METHODS
  A group of 287 patients with opioid dependence was monitored prospectively from 1995 to 2007. At the beginning of the study, we collected the data on patient baseline characteristics, treatment characteristics, and living environment. At the annual check-up, we collected the data on daily methadone dose, method of methadone therapy administration, and family physician's assessment of the patient's drug use status.
  
  
  RESULTS
  Out of 287 patients, 8% died. Logistic regression analysis showed that the predictors of fatal outcome were continuation of drug use during previous therapeutic attempts (odds ratio [OR], 19.402; 95% confidence interval [CI], 1.659-226.873), maintenance therapy as the planned treatment modality (OR, 3.738; 95% CI, 1.045-13.370), living in an unstable relationship (OR, 9.275; 95% CI, 2.207-38.984), and loss of continuity of care (OR, 12.643; 95% CI, 3.001-53.253).
  
  
  CONCLUSIONS
  The patients presenting these risk factors require special attention. It is important for family physicians to insist on compliance with the treatment protocol and intervene when they lose contact with the patient to prevent the fatal outcome.
authors: Department for Family Medicine, University of Zagreb, School of Medicine, Zagreb, Croatia. venija.cerovecki@mef.hr
authors: Venija
authors: V
authors: Cerovečki
authors: Hrvoje
authors: H
authors: Tiljak
authors: Zlata
authors: Z
authors: Ožvačić Adžić
authors: Miljenko
authors: M
authors: Križmarić
authors: Peter
authors: P
authors: Pregelj
authors: Andrej
authors: A
authors: Kastelic
mesh_terms: D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D017523:Croatia; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000188:drug therapy* / Q000401:mortality*; D010349:Patient Compliance; D010821:Physicians, Family; D011320:Primary Health Care; D012307:Risk Factors
chemical_list: D000701:Analgesics, Opioid; D008691:Methadone