title: Patient perception of methadone dose adequacy in methadone maintenance treatment: The role of perceived participation in dosage decisions.
abstract: In clinical practice, methadone maintenance treatment (MMT) entails tailoring the methadone dose to the patient's specific needs, thereby individualizing treatment. The aim of this study was to identify the independent factors that may significantly explain methadone dose adequacy from the patient's perspective.
  
  
  
  Secondary analysis of data collected in a treatment satisfaction survey carried out among a representative sample of MMT patients (n=122) from the region of La Rioja (Spain). As part of the original study protocol, participants completed a comprehensive battery to assess satisfaction with MMT, psychological distress, opinion of methadone as a medication, participation in dosage decisions, and perception of dose adequacy.
  
  
  
  Multivariate binary logistic regression showed that the only variable independently associated with the likelihood of a patient perceiving methadone dose as inadequate was the variable perceived-participation in methadone dosage decisions (OR=0.538, 95% CI=0.349-0.828).
  
  
  
  Patient participation in methadone dosage decisions was predictive of perceived adequacy of methadone dose beyond the contribution of other socio-demographic, clinical, and MMT variables.
  
  
  
  Patient participation in methadone dosage decision-making is valuable for developing a genuinely patient-centred MMT.
authors.affiliation: Addictive Behaviours Unit, Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain; Biomedical Research Networking Center on Mental Health (CIBERSAM), Barcelona, Spain. Electronic address: jtrujols@santpau.cat.
authors.forename: Joan
authors.initials: J
authors.lastname: Trujols
authors.affiliation: Community Mental Health Unit of Villamartín, Mental Health Clinical Management Unit of Hospital de Jerez de la Frontera, Northern Area Health Management of Cádiz, Andalusian Health Service, Spain; Addictive Disorders Network (RTA), Granada, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: González-Saiz
authors.affiliation: Addictive Behaviours Unit, Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain.
authors.forename: María José
authors.initials: MJ
authors.lastname: Manresa
authors.affiliation: Addictive Behaviours Unit, Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain.
authors.forename: Saul
authors.initials: S
authors.lastname: Alcaraz
authors.affiliation: Addictive Behaviours Unit, Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine, Autonomous University of Barcelona (UAB), Bellaterra, Spain.
authors.forename: Francesca
authors.initials: F
authors.lastname: Batlle
authors.affiliation: Addictive Behaviours Unit, Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain; Biomedical Research Networking Center on Mental Health (CIBERSAM), Barcelona, Spain.
authors.forename: Santiago
authors.initials: S
authors.lastname: Duran-Sindreu
authors.affiliation: Addictive Behaviours Unit, Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain; Biomedical Research Networking Center on Mental Health (CIBERSAM), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine, Autonomous University of Barcelona (UAB), Bellaterra, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Pérez de Los Cobos
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000627:therapeutic use; D003142:Communication; D003657:Decision Making; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D054796:Drug Dosage Calculations; D005260:Female; D006801:Humans; D008297:Male; D008691:Methadone / Q000008:administration & dosage / Q000627:therapeutic use*; D058850:Opiate Substitution Treatment / Q000523:psychology*; D009293:Opioid-Related Disorders / Q000188:drug therapy / Q000534:rehabilitation*; D010358:Patient Participation; D017060:Patient Satisfaction; D010465:Perception; D010817:Physician-Patient Relations; D013030:Spain
chemical_list: D000701:Analgesics, Opioid; D008691:Methadone
keywords: Methadone dose; Methadone maintenance treatment; Opioid dependence; Patient participation in dosage decisions; Patient perception of dose adequacy; Patient perspectives; Patient-clinician communication