Prediction of the outcome of inpatient opiate detoxification treatment

TY - JOUR

T1 - Prediction of the outcome of inpatient opiate detoxification treatment

T2 - results from a multicenter study

AU - Specka, Michael

AU - Buchholz, Angela

AU - Kuhlmann, Thomas

AU - Rist, Fred

AU - Scherbaum, Norbert

N1 - Copyright © 2011 S. Karger AG, Basel.

PY - 2011

Y1 - 2011

N2 - BACKGROUND: Monocentric studies of inpatient opiate detoxification treatment show considerable variability regarding treatment success rates. This multicentric study investigates whether patient characteristics explain the different rates of regular discharge between treatment units.METHODS: 1,017 opiate-dependent patients from 12 detoxification units with similar treatment programs, funding, staffing and equipment were analyzed. Patient data and outcomes were documented by treatment staff using a standard form.RESULTS: Controlling for center, regular discharge (range: 14-49% between centers) was significantly associated with pre-existing plans for follow-up treatment, previous completed long-term residential and detoxification treatments, fewer unsuccessful detoxification treatments, higher age, later onset of opiate use, and longer duration of use. Controlling for patient characteristics, the center variable was significantly associated with outcome in a multiple logistic regression analysis.CONCLUSIONS: Regular discharge could best be predicted by patients' plans for follow-up treatment and previous treatment outcomes. Although treatment units had equivalent resources and regulations, and although patient effects were statistically controlled for, there were still considerable center effects. Setting factors as well as actual drop-out processes should be investigated more closely in the future.

AB - BACKGROUND: Monocentric studies of inpatient opiate detoxification treatment show considerable variability regarding treatment success rates. This multicentric study investigates whether patient characteristics explain the different rates of regular discharge between treatment units.METHODS: 1,017 opiate-dependent patients from 12 detoxification units with similar treatment programs, funding, staffing and equipment were analyzed. Patient data and outcomes were documented by treatment staff using a standard form.RESULTS: Controlling for center, regular discharge (range: 14-49% between centers) was significantly associated with pre-existing plans for follow-up treatment, previous completed long-term residential and detoxification treatments, fewer unsuccessful detoxification treatments, higher age, later onset of opiate use, and longer duration of use. Controlling for patient characteristics, the center variable was significantly associated with outcome in a multiple logistic regression analysis.CONCLUSIONS: Regular discharge could best be predicted by patients' plans for follow-up treatment and previous treatment outcomes. Although treatment units had equivalent resources and regulations, and although patient effects were statistically controlled for, there were still considerable center effects. Setting factors as well as actual drop-out processes should be investigated more closely in the future.

KW - Adult

KW - Follow-Up Studies

KW - Hospitalization

KW - Humans

KW - Logistic Models

KW - Male

KW - Methadone

KW - Opioid-Related Disorders

KW - Patient Discharge

KW - Predictive Value of Tests

KW - Substance Abuse Treatment Centers

KW - Time Factors

KW - Treatment Outcome

KW - Young Adult

KW - Comparative Study

KW - Journal Article

KW - Multicenter Study

U2 - 10.1159/000324873

DO - 10.1159/000324873

M3 - SCORING: Journal article

C2 - 21494045

VL - 17

SP - 178

EP - 184

JO - EUR ADDICT RES

JF - EUR ADDICT RES

SN - 1022-6877

IS - 4

ER -