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Effect of community-based extension clinics of methadone maintenance therapy for opiate-dependent clients

机译：美沙酮维持治疗社区扩大诊所对阿片依赖者的影响

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Methadone maintenance therapy (MMT) is effective in treatment of opiate dependents. However, there is a gap between the coverage of standard MMT clinics and the need of opiate dependents. Establishment of extension clinics of methadone maintenance therapy (EMMT) will increase the coverage and improve MMT accessibility. We implemented a prospective cohort study to understand the effects of establishment of community-based EMMT clinics comparing with MMT clinics in Yunnan Province.A total of 462 opiate-dependent clients were interviewed from the community-based EMMT clinics and standard MMT clinics located in 5 counties of Mangshi, Ruili, Longchuan, Yingjiang, and Lianghe in Yunnan Province. The information on the demographic characteristics, drug risk behaviors, quality of life (QOL), and urine testing results for morphine of the clients was collected and compared between the EMMT and MMT clinics. A survival analysis method was utilized to know the retention situation of the newly enrolled clients with Kaplan–Meier method during 9 months treatment.Among the EMMT clients, 96.9% were male; 31.4% were Han; 61.4% were married; 39.0% had primary school education; 95.5% lived with their family or relatives; 96.9% who arrived the clinic less than 15 min; 52.9% had used drugs for more than 10 years; and 16.7% injected drug. After 9 months therapy, there was no difference in the changes of life quality such as physical and psychological features, social relationships, environmental function, and total QOL and well-being between those of EMMT and MMT clinics. The positive detection rate of urine-morphine testing among newly enrolled clients of EMMT clinics decreased as the period of treatment lengthened. The average time of retention for newly enrolled EMMT clients who are still receiving the treatment was 175 days. And the average time from initiations to drop-out of treatment for newly enrolled EMMT clients was 122 days. The 9-month retention rates of the clients were 52.1% and 60.9% at EMMT and MMT clinics, respectively.The effect on EMMT retention was the same as that of MMT. Establishment of EMMT clinics was an effective strategy to expand the coverage of MMT and increase the retention of opiate dependents in the rural areas of the counties.
机译：美沙酮维持疗法（MMT）可有效治疗阿片类药物依赖者。但是，标准MMT诊所的覆盖范围与阿片类药物依赖的需求之间存在差距。建立美沙酮维持治疗（EMMT）扩展诊所将扩大覆盖面并改善MMT的可及性。我们开展了一项前瞻性队列研究，以了解与建立云南省MMT诊所相比，建立社区EMMT诊所的效果。来自社区EMMT诊所和5个标准MMT诊所的462名鸦片依赖患者接受了采访云南省的芒市，瑞丽，龙川，盈江和两河两县。收集并比较了EMMT和MMT诊所之间有关客户的吗啡的人口统计学特征，药物风险行为，生活质量（QOL）和尿液检测结果的信息。用生存分析方法了解新入组客户在治疗9个月期间的保留情况，Kaplan–Meier方法。在EMMT客户中，男性占96.9％；而在EMMT客户中，男性占96.9％。汉族占31.4％； 61.4％已婚； 39.0％具有小学学历； 95.5％与家人或亲戚同住；不到15分钟到达诊所的人占96.9％； 52.9％的人已经使用毒品超过10年；和16.7％的注​​射药物。经过9个月的治疗，EMMT和MMT诊所的生活质量变化（如生理和心理特征，社会关系，环境功能以及总的QOL和幸福感）没有差异。随着治疗时间的延长，EMMT诊所新招募的客户中尿吗啡检测的阳性检出率下降。仍在接受治疗的新注册EMMT客户的平均保留时间为175天。新加入EMMT客户从开始治疗到退出治疗的平均时间为122天。客户在EMMT和MMT诊所的9个月保留率分别为52.1％和60.9％，对EMMT保留率的影响与MMT相同。建立EMMT诊所是扩大MMT覆盖面并增加县农村地区阿片依赖者保留率的有效策略。

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