- 期刊
探討美沙冬替代治療者其藥物信守之相關因素
Factors Related to Medication Adherence in Patients Receiving Methadone Maintenance Therapy
摘要
背景：美沙冬替代治療之藥物信守問題會阻礙海洛因成癮者之治療成效，進而造成復用海洛因與醫療成本增加。目的：探討美沙冬替代治療者信守藥物的相關因素。方法：以橫斷面調查研究設計，採方便取樣選取南部某醫學中心精神科門診之接受美沙冬治療滿一個月非緩起訴個案為研究對象，共120位。研究工具含基本人口學屬性、家庭關懷指數量表、社會支持量表、焦慮量表、決策平衡量表、美沙冬治療遲疑態度問卷。結果：影響藥物信守之相關因素有（1）女性低於男性（X^2=11.98、p=.001）；（2）服用越久者藥物信守越好；（t=2.214、p=.029）；（3）自主神經焦慮反應越強者其服藥信守越低（t=-2.249、p=.026）。結論／實務應用：本研究結果建議應優化女性戒癮者之友善治療環境、考量個別化需求進行跨區異地給藥機制、輔以心理治療因應自主神經焦慮反應等策略來提升美沙冬替代治療者之藥物信守，以減少醫療與社會資源之浪費。
並列摘要
Background: Methadone maintenance therapy is often interrupted by a lack of medication adherence, which triggers a relapse in heroin use and an increase in health-care expenses. Understanding the factors related to medication adherence and developing strategies to increase adherence can increase the success of drug withdrawal programs and reduce waste. Purpose: This study explored the factors related to medication adherence in patients receiving methadone replacement therapy. Methods: A cross-sectional study with convenience sampling was conducted. 120 patients receiving methadone treatment for 1 month without prosecution were recruited from psychiatric clinics in a medical center in southern Taiwan. Demographic data were gathered. Family support, social support, anxiety, drug addiction decision balance scale, and methadone hesitation questionnaire were used for assessment. Results: Factors related to the level of medication adherence were (1) gender (with women exhibiting lower adherence than did men; X^2 = 11.98, p =.001), (2) duration of the medication routine (with patients who took methadone for longer showing superior adherence; t = 2.214, p = .029), and (3) anxiety (with patients who showed higher autonomic anxiety exhibiting lower adherence; t = -2.249, p = .026). Suggestion and conclusion: On the basis of the findings, this study suggests several strategies for improving adherence. Specifically, rehabilitation personnel should provide a female-friendly environment for treatment, consider individual needs during cross-regional drug administration, enhance screening for psychotherapy, and integrate the findings into annual drug addiction trainings.