Relationship between Dose and Retention of Methadon Maintenance Therapy to Drug Dependence Patients in Primary Health Care

https://doi.org/10.22146/jmpf.57922

Lili Musnelina(1*), Jenny Pontoan(2), Bagus Atmana Prasetya(3)

(1) Faculty of Pharmacy, Institute of Science and Technology, Jakarta
(2) Faculty of Pharmacy, Institute of Science and Technology, Jakarta
(3) Faculty of Pharmacy, Institute of Science and Technology, Jakarta
(*) Corresponding Author

Abstract


Methadon maintenance therapy is one of the substitution therapies needed as an approach to harm reduction or the reduction of the adverse effects of drug abuse. This study aims to fix the infinitive relationship doses with retention of drug dependence patients on methadon maintenance therapies program (PTRM) in Kramat Jati Primary Health Care in 2009-2018. A cross-sectional study is conducted using secondary data from medical records subsequently significance analysis. This research involves 136 patients who were included in the inclusion criteria. Results shown mean initial doses received is 27,65 mg (10-40 mg), after 2 weeks of therapy mean doses received are 51,6 mg (range 22,5 – 85 mg). Average lowest and highest maintenance dose which received is 30,9 mg (range 0,25-115 mg) dan 84,39 mg (range 7,77-126,92 mg). This research shows the retention value 1 year or more reaches 64,71%. Maintenance doses 2 weeks (P=0,005), lowest maintenance doses (P=0,000), average maintenance doses (P=0,004), and history misses doses (P=0,000) have significance with retention. The conclusion that the more optimal maintenance doses received, even more in methadone maintenance therapies. Otherwise, lower missed doses frequency better to patients retention in methadon maintenance therapies.

Keywords


Doses; Methadon; PTRM; Retention

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References

  1. Kumar MS. Methadone Maintenance Treatment Intervention Toolkit. United Nations Office on Drugs and Crime, Regional Office for South Asia Author; 2012.
  2. Peraturan Menteri Kesehatan Republik Indonesia Nomor 57 Tahun 2013 Tentang Pedoman Penyelenggaraan Program Terapi Rumatan Metadona. Jakarta: Kementerian Kesehatan Republik Indonesia; 2013.
  3. Kalvik A, Isaac P. The Importance of Missed Doses in Methadone Maintenance Treatment (MMT). Fall-Pharmacy Connection. 2013:22-24.
  4. Bao Y, Liu Z, Epstein DH, Du C, Shi J, Lu L. A Meta-Analysis of Retention in Methadone Maintenance by Dose and Dosing Strategy. Am J Drug Alcohol Abuse. 2009 ; 35(1): 28–33. DOI:10.1080/00952990802342899. Available in PMC 2013 June 21.
  5. Maurice Dematteis M, Auriacombe M, D’Agnone O, Somaini L, Szerman N, Littlewood R, Alam F, Alho H, Benyamina A, Bobes J, Daulouede JP, Leonardi C, Maremmani I, Torrens M, Walcher S, Soyka M. Review Recommendations for Buprenorphine and Methadone Therapy in Opioid Use Disorder: A European consensus. Expert Opinion on Pharmacotherapy. 2017:1-44. DOI: 10.1080/14656566.2017.1409722.
  6. Christie TKS, Murugesan A, Manzer D, O’Shaughnessey MV, and Webster D. Evaluation of a Low-Threshold/High-Tolerance Methadone Maintenance Treatment Clinic in Saint John, New Brunswick, Canada: One Year Retention Rate and Illicit Drug Use. Journal of Addiction. 2013:1-5. Http://dx.doi.org/10.1155/2013/753409.
  7. Maremmani AGI, Pacini M, and Maremmani I. What We Have Learned From The Methadone Maintenance Treatment of Dual Disorder Heroin Use Disorder patients. International Journal of Environmental Research and Public Health. 2019;16: 447. DOI:10.3390/ijerph16030447.
  8. Nicholls L, Bragaw L, Ruetsch C. Opioid Dependence Treatment and Guidelines. Supplement to Journal of Managed Care Pharmacy. 2010; 16(1): 14-21. www.amcp.org.
  9. Lee SY, Chen SL, Chang YH, Chen PS, Huang SY, Tzeng NS, Wang LJ, Lee IH, Wang TY, Chen KC, Yang YK, Hong JS, Lu RB. Low-Dose Memantine Attenuated Methadone Dose in Opioid Dependent Patients: a 12-Week Double-Blind Randomized Controlled Trial. Scientific Reports. 2015:1-10. DOI: 10.1038/srep10140.
  10. Amato L, Davoli M, Minozzi S, Ferroni E, Ali R, Ferri M. Methadone at Tapered Doses for The Management of Opioid Withdrawal. Cochrane Database of Systematic Reviews 2013, Issue 2. Art. No.: CD003409. DOI: 10.1002/14651858.CD003409.pub4.
  11. Zhang L, Chow EPF, Zhuang X, Liang Y, Wang Y, Tang C, Ling L, Tucker JD, Wilson DP. Methadone Maintenance Treatment Participant Retention and Behavioral Effectiveness in China: A Systematic Review and Meta-Analysis. PLoS ONE. 2013;8(7):e68906. DOI:10.1371/journal.pone.0068906.
  12. Rambe R, Harahap U, Tarigan CJ. Influence of Dosage on Retention in Patients Methadone Maintenance Therapy Program for Maintenance Phase of H. Adam Malik Medan Central General Hospital. Asian Journal of Pharmaceutical and Clinical Research. 2018;11(8):244-247. DOI: http://dx.doi.org/10.22159/ajpcr.2018.v11i8.24743.
  13. Fathollahi MS, Torkashvand F, Najmeddin H, and Rezaeian M. Predictors of One-Year Retention in Methadone Maintenance Treatment (MMT) in Iran, Rafsanjan. Int J High Risk Behav Addict. 2016;5(3):e29121. DOI: 10.5812/ijhrba.29121.
  14. Ismi AN. Efektivitas Program Terapi Rumatan Metadon Bagi Pecandu Heroin Di Puskesmas Kecamatan Tebet. Skripsi. Jakarta: Program Studi Kesejahteraan Sosial, Fakultas Dakwah dan Ilmu Komunikasi, Universitas Islam Negeri Syarif Hidayatullah; 2014.
  15. Pahlemy H. Hubungan Dosis Dan Retensi Pada Terapi Rumatan Metadon Multiepisode Di Rumah Sakit Ketergantungan Obat Jakarta dan Rumah Sakit Umum Pusat Fatmawati. Tesis. Jakarta; Fakultas Matematika dan Ilmu Pengetahuan Alam Program Magister Ilmu Kefarmasian Universitas Indonesia; 2010.
  16. Pratiwi I, Arsyad DS, Ansar J. Faktor Yang Berhubungan Dengan Kepatuhan Berobat Terapi Rumatan Metadon di Puskesmas Kassi Kassi Kota Makassar. Makassar; Hasanuddin University Repository: 2014. OAI:repository.unhas.ac.id:123456789/9386. http://repository.unhas.ac.id.
  17. Diong SH, Yusoff NSM, Sim MS, Aziddin RER, Chik Z, Rajan P, Rashid RA, Chemi N and Mohamed Z. Quantitation of Methadone and Metabolite in Patients under Maintenance Treatment. Journal of Analytical Toxicology. 2014;38:660-666. DOI:10.1093/jat/bku096.
  18. Soyka M, Zingg C, Koller G, and Kuefner H. Retention Rate And Substance Use In Methadone And Buprenorphine Maintenance Therapy And Predictors of Outcome: Results From A Randomized Study. International Journal of Neuropsychopharmacology. 2008;11: 641–653. DOI: 10.1017/S146114570700836.
  19. Baxter K and Preston CL,. (ed). Stockley's Drug Interactions. Tenth edit. London, UK: Pharmaceutical Press; 2013. 1672 p. ISBN: 978-0- 85711-061-9.



DOI: https://doi.org/10.22146/jmpf.57922

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