Work

Poster Abstracts

Year: 2019

Type: article

Abstract: Introduction: Opioid Substitution Treatment (OST) is now the mainstay of treatment in many developed countries.Success of various treatment approaches is assessed in a number of ways with the primary outcomes of interest being retention in treatment.Limited studies have evaluated the predictors of retention in treatment in the Middle East & North Africa (MENA) region.However, Lebanon is one of the first countries in the MENA region to establish a national program using only Buprenorphine due to its pharmacological characteristics and safety profile.Our study aimed to determine the main predictors of retention in the national OST program.Material and methods: A retrospective cohort was conducted during Aug-Oct 2017 in Lebanon.A total of 316 files for adults (age ≥ 18 years) males and females referred from 5 centers were studied.Data about patient's characteristics & treatment were collected from the Opioid Substitution Treatment Information System (OSTIS) database.Psychiatrist's practices & believes were assessed using a questionnaire [1].Logistic regression was used to evaluate the relationship between rates of drop-out & early drop out and independent variables and Cox regression to assess impact of variables on time for drop-out from treatment.All statistical tests were conducted at an a priori significance level of P < 0.05 using SPSS version 22.Results: In our study, 30.7% of patients dropped out from treatment in the first three months, and 31.9%later during the one year follow-up period.Both university (OR 0.088, P = 0.006) and school (OR 0.139, P = 0.012) level were associated with higher retention rate compared to non-education.A significant higher rate of retention was seen in patients receiving high doses of Buprenorphine (BUP) daily compared to doses <16 mg per day.Male psychiatrists had a 70% lower rate of drop outs compared to females.Other variables related to psychiatrist's practices like adopting a flexible regimen were associated with a higher rate of retention compared to a fixed dosing regimen, (HR 0.537, P < 0.0001).Discussion/Conclusion: These findings suggest a dynamic relationship between patient's characteristics, psychiatrist's practice and retention in treatment that indicates potential directions for future research into positive and negative impact of these factors on treatment.Reference [1] Kasarabada N. et al.A Self-Administered Instrument For Assessing Therapeutic Approaches of Drug Users Treatment Counselors; substance Use & Misuse (2009) 36 273-299.

Source: Fundamental and Clinical Pharmacology

DOI: 10.1111/fcp.12470