Patterns of adherence to oral methadone: Implications for prescribers

Abstract We investigated patterns of nonadherence to substitute treatment among patients attending an inner London community drug dependency unit and explored factors associated with nonadherence. We undertook 91 face-to-face confidential interviews with methadone-maintained patients attending commu...

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Bibliographic Details
Published in:Journal of substance abuse treatment 2008-09, Vol.35 (2), p.109-115
Main Authors: Haskew, Michael, M.B.B.S., M.Sc, Wolff, Kim, Ph.D, Dunn, John, B.Med.Sci., B.M., B.S., M.R.C.Psych., D.M, Bearn, Jenny, M.R.C.P., M.R.C.Psych
Format: Article
Language:English
Subjects:
Adherence
Adolescent
Adult
Assessment
Biological and medical sciences
Community Pharmacy Services
Compliance
Data Collection
Desintoxication. Drug withdrawal
Drug addictions
Effectiveness
Female
Humans
Logistic Models
London
Male
Medical sciences
Methadone
Methadone - therapeutic use
Middle Aged
Narcotics - therapeutic use
Patient Compliance - psychology
Prescriptions
Prevalence
Psychiatry
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Substance abuse treatment
Substance-Related Disorders - rehabilitation
Toxicology
Treatment
Treatment Refusal - psychology
Treatments
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Summary:Abstract We investigated patterns of nonadherence to substitute treatment among patients attending an inner London community drug dependency unit and explored factors associated with nonadherence. We undertook 91 face-to-face confidential interviews with methadone-maintained patients attending community pharmacies. Thirty-eight patients (42%) had been either partial or poor adherers to their prescribed methadone regime in the past month. Multinomial logistic regression revealed that compared to full adherers, both poor adherers and partial adherers were more likely to be prescribed by unsupervised consumption. Poor adherers were also more likely to have less frequent pickups. There were seven types of nonadherent behavior detected, with dose splitting being the most prevalent (34%), followed by dose storage (28%) and missed pickups from the pharmacy (18%). We suggest that prescribers include an assessment of medication adherence at regular patient reviews as supervised consumption does not solve all adherence problems with methadone. New approaches to encouraging adherence, including a more systematic monitoring of adherence to improve the effectiveness of methadone programs, are needed.
ISSN:0740-5472
1873-6483
DOI:10.1016/j.jsat.2007.08.013