目的评价广东省美沙酮维持治疗(Methadone Maintenance Treatment,MMT)门诊辅助服务的开展现状及对退出率的影响。方法 2008年11月20日至2008年12月10日,对广东省2008年9月30日前开诊的所有MMT门诊(共45家)的辅助服务开展现状进行普查,调查内容包括服务类型、内容和形式,结合"社区美沙酮维持治疗管理系统"中的受治者退出治疗记录,评价门诊辅助服务开展现状与退出率的关系。结果45家门诊开展的辅助服务的种类、内容和形式各有不同。服务种类可归纳为咨询、检测/体检、奖励/激励、疾病治疗和文娱活动5类。其中,咨询开展最广(45家,100.0%);疾病治疗开展最少(4家,8.9%)。咨询主要针对知识讲解、心理咨询等5个主题不定期开展,奖励/激励主要针对个人以物质奖励方式开展。辅助服务的开展与退出率有关,开展了奖励/激励、疾病治疗和文娱活动的门诊退出率低于未开展的门诊(P〈0.05)。结论目前广东省MMT项目提供了不同种类的辅助服务,但类型、内容仍然有限,开展形式尚不规范。进一步提高门诊服务能力,丰富服务内容和规范服务形式是促进门诊辅助服务效果的重点。
Objective To evaluate the status of support service for community Methadone Maintenance Treatment(MMT)in Guangdong and its impact on patient discharge rate.Methods During November 20,2008 to December 10,2008,a census was conducted to collect and analyze the status of support service in 45 MMT clinics,which were opened before September 30,2008 in Guangdong.Discharge reports of patients were collected from national MMT management system,and discharge rate was used to evaluate effectiveness of support service.Results Support services in different clinics were conducted with different types,contents and organizational forms.The types of support service carried out in Guangdong included counseling,testing,encouragement,treatment of diseases and recreational activities.Counseling was used widely(in 45 of 45 hospitals,100.0%),while treatment of diseases was used at least(in 4 of 45 clinics,8.9%).Five themes including knowledge,psychological consult were run irregularly in counseling.Material rewards were given to individual by encouragement system.Discharge rate was related to support service implementation,and the rates were lower in those clinics where encouragement,treatment of diseases and recreational activities were carried out(P0.05).Conclusion Several types of support service were conducted in MMT clinics in Guangdong,but the types,contents and forms should be further developed.Service ability,contents and forms should be improved for support service on MMT in future.