{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T03:40:20Z","timestamp":1760240420585,"version":"build-2065373602"},"reference-count":46,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2019,6,6]],"date-time":"2019-06-06T00:00:00Z","timestamp":1559779200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81473065"],"award-info":[{"award-number":["81473065"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Methadone maintenance treatment (MMT) requires patients to intake their daily dose in person at their clinic. Therefore, transfer services are vital for patients who need temporary leave from their primary MMT clinic. However, studies have shown that transfer patients might delay return after temporary leave, leading to missed doses and putting them at risk of increased harm. In this study, we aimed to explore the transfer rates and factors associated with MMT patients who delayed return during a transfer period. In this retrospective analysis, we used audit records from the web-based management system from six MMT clinics in Guangdong, China. Multilevel logistic regression and multilevel Poisson regression analyses were used to examine the factors associated with patients who delayed return to their primary MMT clinic. A total of 459 people used the transfer system 2940 times between January 2006 and December 2016. Of those, patients delayed return to their primary MMT clinic 1199 times (40.78%). Patients who transferred regularly had poor compliance rates with MMT treatment. Those who once dropped out from and then re-enrolled in MMT were more likely to delay return. Most patients (82.71%) who used the transfer service for \u201cwork\u201d were more likely to prolong their delay length. The findings highlight that a more flexible transfer system would minimize inconvenience to the patients.<\/jats:p>","DOI":"10.3390\/ijerph16112023","type":"journal-article","created":{"date-parts":[[2019,6,7]],"date-time":"2019-06-07T03:56:31Z","timestamp":1559879791000},"page":"2023","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Factors Associated with Compliance among Methadone Maintenance Treatment Transfers: Evidence from Audit Records at Clinics in Guangdong, China"],"prefix":"10.3390","volume":"16","author":[{"given":"Cheng","family":"Gong","sequence":"first","affiliation":[{"name":"Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xia","family":"Zou","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qian","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Ling","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2019,6,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1177\/070674370605101003","article-title":"Evidenced-based treatment of opioid-dependent patients","volume":"51","author":"Haasen","year":"2006","journal-title":"Candian J. Psychiatry"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1689","DOI":"10.1001\/jama.284.13.1689","article-title":"Drug dependence, a chronic medical illness: Implications for treatment, insurance, and outcomes evaluation","volume":"284","author":"McLellan","year":"2000","journal-title":"Jama"},{"key":"ref_3","first-page":"462","article-title":"Keeping patients safe from methadone overdoses","volume":"36","author":"Grissinger","year":"2011","journal-title":"Pharm. Ther."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1001\/archpsyc.58.5.503","article-title":"A 33-year follow-up of narcotics addicts","volume":"58","author":"Hser","year":"2001","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"53","DOI":"10.3109\/10826089009056200","article-title":"The influence of prolonged stable methadone maintenance treatment on mortality and employment: An 8-year follow-up","volume":"25","author":"Segest","year":"1990","journal-title":"Int. J. Addict."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1097\/ADM.0b013e318156cc19","article-title":"The effect of methadone maintenance on illicit opioid use, human immunodeficiency virus and hepatitis C virus infection, health status, employment, and criminal activity among heroin abusers during 6 months of treatment in China","volume":"1","author":"Shi","year":"2007","journal-title":"J. Addict. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"429","DOI":"10.47102\/annals-acadmedsg.V39N6p429","article-title":"Monthly take-home methadone maintenance regime for elderly opium-dependent users in Singapore","volume":"39","author":"Guo","year":"2010","journal-title":"Ann. Acad. Med. Singap."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1097\/ADM.0b013e3181e6ad48","article-title":"Earning \u201ctake-home\u201d privileges and long-term outcome in a methadone maintenance treatment program","volume":"5","author":"Peles","year":"2011","journal-title":"J. Addict. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/0376-8716(96)01240-9","article-title":"Prohibition of take-home dosages: Negative consequences on methadone maintenance treatment","volume":"41","author":"Pani","year":"1996","journal-title":"Drug Alcohol Depend."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1111\/j.1753-6405.2010.00484.x","article-title":"The risks of diverted take-home methadone","volume":"34","author":"McGloughlin","year":"2010","journal-title":"Aust. N. Z. J. Public Health"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1093\/ije\/dyq210","article-title":"Scaling up the national methadone maintenance treatment program in China: Achievements and challenges","volume":"39","author":"Yin","year":"2010","journal-title":"Int. J. Epidemiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1016\/j.pnpbp.2010.12.002","article-title":"Supervised daily consumption, contingent take-home incentive and non-contingent take-home in methadone maintenance","volume":"35","author":"Gerra","year":"2011","journal-title":"Prog. Neuro-Psychopharmacol. Biol. Psychiatry"},{"key":"ref_13","unstructured":"China Food and Drug Administration (2015). Guidelines on the Management of Methadone Maintenance Treatment in China."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1136\/jrnms-52-150","article-title":"Drug dependence","volume":"52","author":"Marjot","year":"1966","journal-title":"J. R. Nav. Med. Serv."},{"key":"ref_15","unstructured":"WHO (2009). Guidelines for the Psychosocially Assisted Pharmacological Treatment of Opioid Dependence, WHO."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1111\/add.12781","article-title":"Who uses methadone services in China? Monitoring the world\u2019s largest methadone programm","volume":"110","author":"Sullivan","year":"2015","journal-title":"Addiction"},{"key":"ref_17","unstructured":"The College of Physicians & Surgeons of Manitoba (2014). Guideline of Manitoba Methadone & Buprenorphine Maintenance, University of Manitoba."},{"key":"ref_18","unstructured":"Department of Health, and Ministry of Health (2012). Guideline on Methadone Therapy and Treatment of Drug Dependence in Myanmar, WHO."},{"key":"ref_19","unstructured":"British Columbia Centre on Substance Use, and Ministry of Health (2014). Methadone Maintenance Program."},{"key":"ref_20","unstructured":"WHO China Office (2014, November 27). Reducing Harm, Preventing HIV, Saving Lives: China\u2019s Vast Methadone Maintenance Treatment Program Marks Successes Even as It Addresses Key Challenges Ahead. Available online: http:\/\/www.wpro.who.int\/china\/mediacentre\/releases\/2014\/2014112702\/en\/."},{"key":"ref_21","first-page":"262","article-title":"Analysis of drug compliance for transfer patients in methadone maintenance treatment","volume":"15","author":"Li","year":"2009","journal-title":"Chin. J. Drug Abus. Prev. Treat."},{"key":"ref_22","first-page":"366","article-title":"Comparative analysis for transferred patients and local patients in methadone maintenance treatment","volume":"19","author":"Peng","year":"2010","journal-title":"Chin. Drug Depend."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1186\/s13011-017-0115-4","article-title":"Adherence to methadone maintenance treatment and associated factors among patients in vietnamese mountainside areas","volume":"12","author":"Nguyen","year":"2017","journal-title":"Subst. Abus. Treat. Prev. Policy"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"4097","DOI":"10.2174\/13816128113199990623","article-title":"Predictors of non-adherence to methadone maintenance treatment in opioid-dependent individuals: Implications for clinicians","volume":"20","author":"Roux","year":"2014","journal-title":"Curr. Pharm. Des"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1097\/ADM.0000000000000180","article-title":"Predictors of poor adherence to methadone maintenance treatment in Yunnan province, China","volume":"10","author":"Shen","year":"2016","journal-title":"J. Addict. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1097\/00007691-200208000-00001","article-title":"Characterization of methadone overdose: Clinical considerations and the scientific evidence","volume":"24","author":"Wolff","year":"2002","journal-title":"Ther. Drug Monit."},{"key":"ref_27","unstructured":"China National Narcotic Control Committee (2017). China Drug Report, China National Narcotic Control Committee."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Chen, T., and Zhao, M. (2019). Meeting the challenges of opioid dependence in China: Experience of opioid agonist treatment. Curr. Opin. Psychiatry.","DOI":"10.1097\/YCO.0000000000000509"},{"key":"ref_29","first-page":"648","article-title":"Overdose of heroin and influencing factors in intravenous drug users in parts of Yunnan","volume":"37","author":"Zhou","year":"2016","journal-title":"China J. Epidemiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1081\/JA-120002807","article-title":"Canadian illicit opiate users\u2019 views on methadone and other opiate prescription treatment: An exploratory qualitative study","volume":"37","author":"Fischer","year":"2002","journal-title":"Subst. Use Misuse"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/j.jsat.2011.12.008","article-title":"Addiction treatment-related employment barriers: The impact of methadone maintenance","volume":"43","author":"Richardson","year":"2012","journal-title":"J. Subst. Abus. Treat."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e016153","DOI":"10.1136\/bmjopen-2017-016153","article-title":"Ability to join the workforce and work productivity among drug users under methadone maintenance treatment in a mountainous area of Northern Vietnam: A cross-sectional study","volume":"7","author":"Nong","year":"2017","journal-title":"BMJ Open"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/1747-597X-9-11","article-title":"Factors associated with one year retention to methadone maintenance treatment program among patients with heroin dependence in China","volume":"9","author":"Jiang","year":"2014","journal-title":"Subst. Abus. Treat. Prev. Policy"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1097\/ADM.0b013e31829da05b","article-title":"A study of 6-year retention in methadone maintenance treatment among opioid-dependent patients in Xi\u2019an","volume":"7","author":"Wei","year":"2013","journal-title":"J. Addict. Med."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Tran, B.X., Nguyen, L.H., Tran, T.T., and Latkin, C.A. (2018). Social and structural barriers for adherence to methadone maintenance treatment among Vietnamese opioid dependence patients. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0190941"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.1080\/10826084.2016.1276598","article-title":"Comparison between urinalysis results and self-reported heroin use among patients undergoing methadone maintenance treatment in china","volume":"52","author":"Li","year":"2017","journal-title":"Subst. Use Misuse"},{"key":"ref_37","first-page":"347","article-title":"Methadone maintenance treatment (MMT): A review of historical and clinical issues","volume":"67","author":"Joseph","year":"2000","journal-title":"Mount Sinai J. Med."},{"key":"ref_38","first-page":"287","article-title":"Rate of adherence to and factors associated with methadone maintenance treatment program (Mmtp) compliance among Injecting drug use Patients In nepal","volume":"47","author":"Sharma","year":"2016","journal-title":"Southeast Asian J. Trop. Med. Public Health"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Huissoud, T., Rousson, V., and Dubois-Arber, F. (2012). Methadone treatments in a swiss region, 2001\u20132008: A registry-based analysis. BMC Psychiatry, 12.","DOI":"10.1186\/1471-244X-12-238"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"749","DOI":"10.3109\/10826084.2010.534124","article-title":"New community-based Methadone maintenance treatment programs in Guangdong, China, and their impact on patient quality of life. Subst","volume":"46","author":"He","year":"2011","journal-title":"Use Misuse"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.drugalcdep.2005.05.010","article-title":"Cycling in and out of treatment; participation in methadone treatment in NSW, 1990\u20132002","volume":"81","author":"Bell","year":"2006","journal-title":"Drug Alcohol Depend."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/0306-4603(77)90003-X","article-title":"Medication take-home as a reinforcer in a methadone maintenance program","volume":"2","author":"Stitzer","year":"1977","journal-title":"Addict. Behav."},{"key":"ref_43","first-page":"405","article-title":"Take home maintenance medication in opiate dependence","volume":"110","author":"Gutwinski","year":"2013","journal-title":"Deutsch. Arztebl. Int."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1037\/0022-006X.60.6.927","article-title":"Contingent take-home incentive: Effects on drug use of methadone maintenance patients","volume":"60","author":"Stitzer","year":"1992","journal-title":"J. Consult. Clin. Psychol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"20879","DOI":"10.7448\/IAS.19.4.20879","article-title":"Barriers to community-based drug dependence treatment: Implications for police roles, collaborations and performance indicators","volume":"19","author":"Ma","year":"2016","journal-title":"J. Int. AIDS Soc."},{"key":"ref_46","unstructured":"Baran, C. (2018, July 06). Government Officials and Global Fund Implementers from Kenya, Tanzania, and Uganda Traveled to China to Learn about Local Innovations in Methadone Maintenance. Available online: Therapy. http:\/\/aidspan.org\/gfo_article\/global-fund-multi-country-program-east-africa-spearheads-trip-china-learn-about-harm 2018."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/16\/11\/2023\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T12:56:43Z","timestamp":1760187403000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/16\/11\/2023"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6,6]]},"references-count":46,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2019,6]]}},"alternative-id":["ijerph16112023"],"URL":"https:\/\/doi.org\/10.3390\/ijerph16112023","relation":{},"ISSN":["1660-4601"],"issn-type":[{"type":"electronic","value":"1660-4601"}],"subject":[],"published":{"date-parts":[[2019,6,6]]}}}