tailieunhanh - báo cáo khoa học: " Patient and clinician’s ratings of improvement in methadone-maintained patients: Differing perspectives?"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Patient and clinician’s ratings of improvement in methadone-maintained patients: Differing perspectives? | Trujols et al. Harm Reduction Journal 2011 8 23 http content 8 1 23 HARM REDUCTION JOURNAL RESEARCH Open Access Patient and clinician s ratings of improvement in methadone-maintained patients Differing perspectives 1 1 2 13 1 Joan Trujols Núria Sinol Ioseba Iraurgi Francisca Batlle Joan Guàrdia and José Pérez de los Cobos Abstract Background In the last few years there seems to be an emerging interest for including the patients perspective in assessing methadone maintenance treatment MMT with treatment satisfaction surveys being the most commonly-used method of incorporating this point of view. The present study considers the perspective of patients on MMT when assessing the outcomes of this treatment acknowledging the validity of this approach as an indicator. The primary aim of this study is to evaluate the concordance between improvement assessment performed by two members of the clinical staff a psychiatrist and a nurse and assessment carried out by MMT patients themselves. Method Patients n 110 and their respective psychiatrist n 5 and nurse n 1 completed a scale for assessing how the patient s condition had changed from the beginning of MMT using the Patient Global Impression of Improvement scale PGI-I and the Clinical Global Impression of Improvement scale CGI-I respectively. Results The global improvement assessed by patients showed weak concordance with the assessments made by nurses Quadratic-weighted kappa p and by psychiatrists Quadratic-weighted kappa p although in the latter concordance was statistically significant. The percentage of improved patients was significantly higher in the case of the assessments made by patients compared with those made by nurses vs. 80 Z-statistic p and by psychiatrists vs. 50 Z-statistic p . Conclusions MMT patients perception of improvement shows low concordance with the clinical staff s perspective. Assessment of MMT effectiveness .