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n Health SA Gesondheid - Predictors of treatment non-adherence in an inpatient substance abuse rehabilitation programme

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Abstract

The research study aimed to identify the factors contributing to premature termination of treatment for substance addiction. The investigation took the form of a differential research design based on archival data obtained from patient files at an inpatient drug rehabilitation centre in Gauteng. One independent variable (treatment adherence) and five dependent variables (past and present patterns of scheduled medication use, legal history and DSM-IV-TR Axis I and II co-morbidity) were chosen. Eighty-five patient files were drawn, constituting 41 treatment adherent and 44 treatment non-adherent addicts. Extraneous variables of age, age of onset, duration of addiction, previous treatment history, drug of choice, current physical health status, gender, race, and level of education were equivalent in both samples. Univariate analysis indicated that treatment adherent and drop-out groups differed significantly in terms of legal history (Fisher's exact test = 12.369; p = 0.002) and past patterns of use of scheduled medication (Fisher's exact test = 29.131; p = 0.000). A logistic regression indicated that a history of abusing a combination of scheduled psychiatric and other medication prior to treatment is the single most accurate predictor of treatment non-adherence (Wald statistic = 11.1035, p = 0.0009). Although certain combinations of past medication patterns and legal history increase predicted probabilities of treatment non-adherence, legal history on its own failed to explain any further variance that past medication could not explain on its own.

Die doel van die navorsingsprojek was om faktore wat bydra tot premature staking van dwelmrehabilitasie te identifiseer. Die ondersoek het die vorm van 'n differensiële navorsingsontwerp met argivale data as basis aangeneem wat by 'n binnepasiëntdwelmrehabilitasiesentrum in Gauteng verkry is. Een onafhanklike veranderlike (behandelingsnakoming) en vyf afhanklike veranderlikes (eertydse en huidige tendense van geskeduleerde medikasieverbruik, geregtelike verlede en DSM-IV-TR Aksis I en II komorbiditeit) is gekies vir die doel van die studie. Daar is 85 pasiëntlêers geselekteer wat bestaan het uit 41 behandelingvoltooiers en 44 behandelingstakers. Eksterne verandelikes van ouderdom, ouderdom van aanvang, duur van verslawing, vorige behandelingsgeskiedenis, dwelm van keuse, huidige fisiese gesondheidstatus, geslag, ras en vlak van onderwys was ekwivalent in beide steekproewe. Eenveranderlike analise het aangedui dat behandelingvoltooiers en stakers beduidend verskil het betreffende geregtelike verlede (Fisher se eksakte toets = 12.369; p = 0.002) en tendense van geskeduleerde medikasieverbruik voor opname (Fisher se eksakte toets = 29.131; p = 0.000). 'n Logistiese regressie het aangedui dat 'n geskiedenis van misbruik van 'n mengsel van psigiatriese en ander medikasie die enkel mees presiese voorspeller van behandelingstaking was (Wald statistiek = 11.1035, p = 0.0009). Hoewel sekere kombinasies van voormalige medikasie gebruikspatrone en geregtelike verlede die voorspelde waarskynlikheid van behandelingstaking vermeerder het, kon geregtelike verlede op op sigself geen verdere variansie verklaar, wat nie reeds deur medikasiegebruikspartone verklaar is nie.

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/content/health/12/4/EJC35031
2007-12-01
2016-12-05
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