patient and clinicians ratings of improvement in methadone-maintained patients differing perspectives病人和医生的评级methadone-maintained改善病人的不同的观点.pdfVIP

Trujols et al. Harm Reduction Journal 2011, 8:23 /content/8/1/23 RESEARCH Open Access Patient and clinician’s ratings of improvement in methadone-maintained patients: Differing perspectives? 1* 1 2 1 3 1 Joan Trujols , Núria Siñol , 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 = 0.13, p 0.05) and by psychiatrists (Quadratic-weighted kappa = 0.19, p = 0.0086), although in the latter, concordance was statistically significant. The percentage of improved patients was significantly higher in the case of the assessments m