Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 2 de 2
Filtrar
Más filtros

Métodos Terapéuticos y Terapias MTCI
Bases de datos
País/Región como asunto
Tipo del documento
País de afiliación
Intervalo de año de publicación
1.
J Subst Abuse Treat ; 138: 108753, 2022 07.
Artículo en Inglés | MEDLINE | ID: mdl-35277307

RESUMEN

BACKGROUND: Few studies have directly compared patient characteristics and retention among those enrolled in methadone maintenance treatment (MMT) based on housing status. Low-barrier-to-treatment-access programs may be particularly effective at attracting patients experiencing homelessness into MMT; however, the literature on retention in such settings is limited. METHODS: We performed a retrospective chart review of 488 consecutive patients enrolled from April to October 2017 at low-barrier-to-treatment-access MMT programs in southern New England. Patients completed measures of demographics, social isolation, trauma, chronic pain, smoking behavior, and psychiatric distress. The study investigated associations between housing status and correlates with chi-square and Mann-Whitney U tests while controlling the False Discovery Rate. A two-sample log-rank test examined the relationship between retention and housing status. The study further scrutinized this association by regressing retention on all covariates using a Cox proportional hazards model. RESULTS: Forty-six patients (9.4%) reported experiencing homelessness and 442 (90.6%) reported being housed. Thirty-seven percent of patients self-identified as female and 20% as non-white. Compared to patients who were housed, those experiencing homelessness had lower rates of recent employment; higher rates of social isolation, trauma, current chronic pain, and recent cannabis use; and higher overall psychiatric distress (all p < 0.01). At one year, overall retention was 51.8%, and retention was 32.6% in the unhoused group and 53.8% in the housed group. A significant negative association occurred between retention and housing status (p = 0.006). After regressing on all covariates, homelessness was associated with a 69% increase in one-year treatment discontinuation (HR = 1.69 for homelessness, CI = 1.14-2.50). CONCLUSIONS: Patients entering MMT experiencing homelessness have multiple clinical vulnerabilities and are at increased risk for 12-month MMT discontinuation. Low-barrier-to-treatment-access MMT programs are an important venue for identifying and addressing vulnerabilities associated with homelessness.


Asunto(s)
Dolor Crónico , Metadona , Dolor Crónico/tratamiento farmacológico , Estudios de Cohortes , Femenino , Vivienda , Humanos , Metadona/uso terapéutico , Tratamiento de Sustitución de Opiáceos , Estudios Retrospectivos
2.
Qual Health Res ; 27(13): 2057-2070, 2017 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-28942704

RESUMEN

Methadone maintenance therapy (MMT) treats opioid use disorder among people who inject drugs (PWID). To understand why PWID may voluntarily discontinue MMT, we analyzed data from 25 focus groups conducted in five Ukrainian cities from February to April 2013 with 199 participants who were currently, previously, or never on MMT. Using constant comparison method, we uncovered three themes explaining why PWID transition off MMT: (a) purposeful resistance to rigid social control associated with how MMT is delivered and to power asymmetries in provider-patient relationships, (b) self-management of a PWID's "wounded identity" that is common in socially stigmatized and physically sick persons-MMT serves as a reminder of their illness, and (c) the quest for a "normal life" uninterrupted by daily MMT site visits, harassment, and time inefficiencies, resources, and social capital. Focusing on holistic principles of recovery would improve addiction treatment and HIV prevention in Ukraine and globally.


Asunto(s)
Metadona/uso terapéutico , Tratamiento de Sustitución de Opiáceos/psicología , Trastornos Relacionados con Opioides/tratamiento farmacológico , Aceptación de la Atención de Salud/psicología , Abuso de Sustancias por Vía Intravenosa/tratamiento farmacológico , Abuso de Sustancias por Vía Intravenosa/psicología , Adulto , Consumidores de Drogas/psicología , Femenino , Grupos Focales , Humanos , Masculino , Metadona/administración & dosificación , Relaciones Profesional-Paciente , Automanejo , Ucrania
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA