A. O. Abagiu 1
1 MD, PhD, Hubert Horatio Humphrey 2008/2009 Alumni, Senior doctor in infectious diseases – National Institute for Infectious Diseases “Prof. Dr. Matei Balş” Bucharest; Medical coordinator of the first low threshold methadone maintenance center in Bucharest
Abstract
Objective: To emphasize the best practice approach issues for retaining addicted patients on substitution treatment in an outpatient center. I have done a literature search of MEDLINE/PUBMED, CINAHAL and COCHRANE COLLABORATION using the following search terms: retention, substance abuse outpatient treatment, best practice. Study Selection: Pertinent English-language human studies and book chapters from 01.01.2004 until 31.12.2008 were reviewed. Data Synthesis: The main issues found in the literature regarding the improvement of retention in treatment and correlated with treatment management are: higher rather than lower doses of methadone, multiple interdisciplinary assessment approach with concomitant psychotherapy and rehabilitation counseling, family or close relatives involvement and location of the unit nearby or better within a hospital. We want to emphasize that other existent factors correlated with better retention like older age, less contact with the criminal justice system and former participation in an MMT cannot be improved in designing the model for a best practice facility. Conclusions: Best issues for retaining patients on maintenance treatment are mainly: integrated multidisciplinary approach, usage of rather higher doses of treatment, family or close ones involvement and placing the facility within a hospital.