title: Modeling the impact of place on individual methadone treatment outcomes in a national longitudinal cohort study.
abstract: BACKGROUND
  Little has been published on the effect of geography on methadone treatment outcomes.
  
  
  OBJECTIVE
  To measure the effect of place on longitudinal outcomes Methods: From 2003 to 2006, 215 clients were recruited to a cohort study of methadone treatment. Participants had their address and clinic geocoded. Treatment outcomes were measured at intake, at one and three years posttreatment using the Maudsley Addiction Profile instrument. Spider diagrams and buffer rings were used to visually map clinics and clients. Regression models were used to measure the effect of place.
  
  
  RESULTS
  Client's accommodation and social and criminal problems in the region had a medium to large effect on heroin use. Analysis of buffer rings revealed that clients located within a 10-km radius of a major clinic demonstrated poorer outcomes in terms of heroin use. Conclusion/Importance: Findings illustrated the relevance of geography on drug treatment outcomes and the planning of services.
authors.affiliation: School of Nursing and Midwifery, Trinity College Dublin , Dublin , Ireland.
authors.forename: Emma
authors.initials: E
authors.lastname: Murphy
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Comiskey
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005843:Geography / Q000706:statistics & numerical data; D006556:Heroin Dependence / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D058850:Opiate Substitution Treatment / Q000379:methods* / Q000706:statistics & numerical data; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D008691:Methadone
keywords: GIS; cohort; heroin; longitudinal; methadone; outcome; regional; spread; treatment; urban