Patient Preference and Adherence (Jul 2018)
Heroin-dependent patient satisfaction with methadone as a medication influences satisfaction with basic interventions delivered by staff to implement methadone maintenance treatment
Abstract
Saul Alcaraz,1 Carme Viladrich,2 Joan Trujols,1,3 Núria Siñol,1 José Pérez de los Cobos1,3,4 1Addictive Behaviors Unit, Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain; 2Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain; 3Biomedical Research Networking Center on Mental Health (CIBERSAM), Madrid, Spain; 4Department of Psychiatry and Legal Medicine, School of Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain Purpose: The aim of the present study was to test a structural equation model of patient satisfaction with different key facets of methadone maintenance treatment (MMT). In this model, the three dimensions of patient satisfaction with methadone as a medication (ie, personal functioning and well-being, anti-addictive effect on heroin, and anti-addictive effect on non-opioid substances) were expected to predict satisfaction with the basic interventions delivered by the staff of treatment centers to implement MMT.Patients and methods: A sample of 210 heroin-dependent patients, resistant to MMT treatment (mean age =41.66 years, SD =6.50; 75.7% male), participated voluntarily in this study. Preliminary analysis based on exploratory structural equation modeling supported the expected three-factor measurement model of the scale to assess satisfaction with medications for addiction treatment – methadone for heroin addiction. Moreover, the 15 items measuring staff’s basic interventions were shown to be compatible with the expected single-factor measurement model. Then, both measurement models were included in a structural model.Results: Results of this model show that patient satisfaction with the compatibility of methadone with personal functioning and well-being, as well as with the anti-addictive effects of methadone on non-opioid substances, predicts satisfaction with basic interventions conducted at methadone treatment centers (β=0.191 and β=0.152, respectively).Conclusion: Our results provide further understanding regarding patient satisfaction with MMT, which could help professionals to better understand patient perspective and experience during MMT. Keywords: exploratory structural equation modeling, satisfaction with medication, satisfaction with treatment, treatment quality, methadone non-responders
