PubMed Health⌕ Search

Biomedical subjects

Joan Trujols

Publications and source records attributed to Joan Trujols.

9 recordsLinked to original sources

Patient perspectives on methadone maintenance treatment in the Valencia Region: dose adjustment, participation in dosage regulation, and satisfaction with treatment.

Desired adjustment of methadone dose, perceived participation in dosage regulation, and satisfaction with methadone treatment centres were assessed in a sample of opioid-dependent patients from the Valencia Region (eastern Spain). An independent interviewer asked 278 consecutively arriving patients to answer the survey, and 165 (59.4%) completed it. Adjustment of methadone dose was assessed with a -10 to +10 visual analogue scale (VAS-MD); participation in methadone dose regulation, with specific questions; and patient satisfaction, with the Verona Service Satisfaction Scale for methadone treatment (VSSS-MT). The methadone dose (mg/d) prescribed by physicians was (mean+/-S.D.) 68.0+/-30.4. Participants scored -1.0+/-4.7 on the VAS-MD, indicating a significant downward desired adjustment of methadone dose (95% CI of -1.73 to -0.30). Of the patients surveyed, approximately one-third were, overall, content with their participation in methadone dose regulation. Overall, participants felt slightly satisfied (VSSS-MT=3.5+/-0.6) with the centres. Patients treated with a methadone dose of < 60 mg/d felt more satisfied than those treated with 60-100 mg/d. Information about dose changes was the only continuous methadone dose variable related with satisfaction that was found in a multiple regression analysis, which accounted for only 2.0% of the variance in VSSS-MT overall scores. In conclusion, patients' opinions on methadone dose and patient satisfaction are only very weakly related when methadone treatment is implemented as in the Valencia Region.

Adolescent↗

A satisfaction survey of opioid-dependent clients at methadone treatment centres in Spain.

A survey was carried out to evaluate the satisfaction with methadone treatment centres of methadone-maintained opioid-dependent patients from Spain. Independent interviewers asked 505 consecutively arriving clients from 20 randomly selected centres (14 conventional centres, two bus units, and four prisons) to participate; 370 (73.3%) clients agreed to fill out the questionnaire, and 351 (69.5%) completed it. Satisfaction was assessed using the Verona Service Satisfaction Scale for methadone treatment (VSSS-MT). The prison sub-sample (n=43) was excluded from overall analysis because survey acceptance and satisfaction was very different in prisons than in the other centres. Mean overall satisfaction in the non-prison sub-sample (n=308) was 3.5 (S.D.=0.6) on a 1-5 point scale (1=terrible; 5=excellent). The percentage of these clients who felt dissatisfied (VSSS-MT scores: < or =3) and satisfied (VSSS-MT scores: >3) was, by category: overall satisfaction, 15.9% dissatisfied, 84.1% satisfied; basic interventions, 16.0% versus 84.0%; specific interventions, 45.4% versus 54.6%; social worker skills, 33.8% versus 66.2%; psychologist skills, 38.5% versus 61.5%. The number of hours per week that the centre dispensed methadone was the only variable able to predict satisfaction. This regression model accounted for only 2.5% of the variance in VSSS-MT overall scores. These results show that Spanish clients are slightly satisfied with conventional centres and bus units, although they fail to detect specific variables that are strongly related to that satisfaction.

Adolescent↗

Development and psychometric properties of the Verona Service Satisfaction Scale for methadone-treated opioid-dependent patients (VSSS-MT).

We adapted the 32-item Verona Service Satisfaction Scale (VSSS-32) to assess opioid-dependent patient satisfaction with services received from methadone treatment centres. The preliminary version of the VSSS for methadone treatment (VSSS-MT) was filled out anonymously and completed by 516 randomly recruited patients. After exploratory factor analysis and item refinement, the definitive 27-item VSSS-MT accounted for 58.8% of the total variance, comprising four factors: Basic Interventions, Specific Interventions, Social Worker Skills, and Psychologist Skills. These factors showed good to excellent internal reliabilities (Chronbach's alpha: 0.91, 0.85, 0.87, and 0.92, respectively). At test-retest, intraclass correlation coefficients of VSSS-MT overall and factor scores were fair to good. The results of this study suggest that the VSSS-MT measures, briefly but also multidimensionally, opioid-dependent patient satisfaction with methadone treatment centres.

Adult↗

The apomorphine test: a biological marker for heroin dependence disorder?

This experimental study was conducted in the inpatient detoxification addictive behavior unit of the Sant Pau Hospital in Barcelona and included 22 healthy subjects (HS) and 42 intravenous heroin-dependent subjects (HDS). Apomorphine-induced yawning rates were investigated in three different groups; heroin-dependent patients stabilized on d-propoxiphene, heroin-dependent patients recently withdrawn from d-propoxiphene and normal controls. Yawning responses were recorded continuously by independent observers for periods of 45 minutes following administration of low doses of subcutaneous apomorphine and NaCl. The lowest subcutaneous apomorphine dose able to induce a significantly higher number of yawning responses in HS was 0.005 mg/kg. The yawning responses induced by this dose in HDS were also significantly higher than those induced by placebo. When comparing the number of yawning responses between the study groups, differences were observed only between HDS and HS and no effect of gender was obtained. The apomorphine test may be useful in assessing central dopamine system alterations associated with chronic heroin consumption and could be a stable and reliable biological marker of heroin-dependence disorders.

Adult↗

A double-blind, placebo-controlled study of naltrexone in the treatment of alcohol-dependence disorder: results from a multicenter clinical trial.

BACKGROUND: A 12-week, multicenter, double-blind, randomized, parallel-group clinical trial to compare naltrexone and placebo was carried out to determine the efficacy, safety, and tolerability of naltrexone together with a psychosocial intervention in the treatment of alcoholism. METHODS: A total of 202 alcohol-dependent patients were assigned to 12 weeks' treatment with either naltrexone or placebo. The relapse rate was evaluated by means of intention-to-treat analyses. Alcohol consumption, craving, adverse events, and changes in the biochemical markers of heavy drinking and possible toxicity were evaluated in the 192 patients who were considered to be assessable. RESULTS: The survival function for patients who were treated with naltrexone was significantly better than that of the patients who were treated with placebo (Kaplan-Meier log rank = 4, df = 1, p < 0.05). In addition, 7.9% of patients who were treated with naltrexone relapsed as compared with 18.8% of those who received placebo [chi = 5.89, df = 2, p = 0.050]. In comparing naltrexone with placebo-treated patients, the most common adverse events were abdominal pain [8.6% vs. 1%; (chi = 6.1, df = 1, p < 0.05)] and headache [7.5% vs. 1% (chi = 5.1, df = 1, p < 0.05)]. CONCLUSIONS: Naltrexone was well-tolerated, as the rate of adverse events was low, and safe, as it did not interfere with the normalization of biochemical markers of heavy drinking or alter liver function markers. Naltrexone seemed to reduce relapse rate to heavy drinking, but we found no differences in other alcohol consumption variables between naltrexone- and placebo-treated groups. Although the naltrexone group showed a tendency to consume fewer drinks per drinking day and had a longer time to first drink, differences were not statistically significant.

Adult↗