Patient perspectives on methadone maintenance treatment in the Valencia Region: Dose adjustment, participation in dosage regulation, and satisfaction with treatment

ENGLISH :
Desired adjustment of methadone dose, perceived participation in dosage regulation, and satisfaction with methadone treatment centres were assessed in a sample of opioid-dependent patients from the Valencia Region (eastern Spain). An independent interviewer asked 278 consecutively arriving patients to answer the survey, and 165 (59,4 %) completed it. Adjustment of methadone dose was assessed with a -10 to +10 visual analogue scale (VAS-MD) ; participation in methadone dose regulation, with specific questions ; and patient satisfaction, with the Verona Service Satisfaction Scale for methadone treatment (VSSS-MT). The methadone dose (mg/d) prescribed by physicians was (mean + S.D.) 68,0 + 30,4. Participants scored -1,0 + 4,7 on the VAS-MD, indicating a significant downward desired adjustment of methadone dose (95 % CI of -1,73 to -0,30). Of the patients surveyed, approximately one-third were, overall, content with their participation in methadone dose regulation. Overall, participants felt slightly satisfied (VSSS-MT = 3,5 + 0,6) with the centres. Patients treated with a methadone dose of <60 mg/d felt more satisfied than those treated with 60-100 mg/d. Information about dose changes was the only continuous methadone dose variable related with satisfaction that was found in a multiple regression analysis, which accounted for only 2,0 % of the variance in VSSS-MT overall scores. In conclusion, patients' opinions on methadone dose and patient satisfaction are only very weakly related when methadone treatment is implemented as in the Valencia Region. (Review's abstract.)