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

Abstract

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.