Kristiana Siste Kurniasanti
Head of Department of Psychiatry Cipto Mangunkusumo Hospital – Universitas Indonesia
Dr. Kristiana Siste graduated from University of Indonesia, subspecialized in addiction psychiatrist. As lecturer, she developed addiction module for undergraduate and trainee programs, and one-stop services for alcohol and behavioral addiction patients in Cipto Mangunkusomo Hospital, Jakarta. She researched on cannabis, HIV/AIDS and Internet addiction. She has been granted scholarship for addiction training in Japan, Adelaide, and Netherlands. In 2014, she received travel award for International Society Addiction Medicine (ISAM).
Statement of the Problem: In Indonesia, about 4 million people aged between 10 to 59 years old used illegal drugs in 2014 and around 15% of those were injecting drug users (IDUs) associated with the HIV/AIDS cases. Methadone maintenance treatment (MMT) was conducted in Indonesia as a harm reduction program focusing on IDUs. Despite its effectiveness and advantages, several drop outs were recorded. Predictor factors, such as program, patient and social characteristics, were needed to assess the treatment retention. This study aimed to evaluate the rate and to identify the predictors of MMT retention among patients with opioid dependence in Indonesia.
Methodology & Theoretical Orientation: This study was a quantitative research conducted on 264 subjects with opioid dependence who met the inclusion and exclusion criteria through consecutive sampling established in four community health centers in Jakarta. They were measured for independent variables using geographic data, SCL-90, ASI, and URICA, before started the MMT. On the third and sixth month, they were evaluated and measured for retention. The data were analysed using univariate Chi-square/ Mann-Whitney test and multivariate logistic regression test.
Findings: Among 264 subjects who enrolled in this study, 227 were male (86.0%) and 37 were female (14.0%), aged 29-37 years old and received 50.0-133.8 mg of methadone dose. There was no subject who lost to follow-up. The retention rate was 91.3% (n=241) after 6 months. Predictors of retention found in the study including (1) financial support (p=0.029); (2) history of psychiatric problem (p=0.031); (3) action motivation (p=0.004); and (4) contemplation motivation (p=0.016).
Conclusion & Significance: From the study, we can conclude that financial support and history of psychiatric problem were positive predictors for MMT retention. Furthermore, motivation did contribute to the retention. While contemplation motivation was a positive predictor for retention, action motivation proven otherwise. Therefore, intervention program is needed for the patients who are prone to drop out.