Adherence to substitute opioid prescribing: Survey of inner-London drug services

Abstract

AIMS AND METHOD: To investigate non-adherence to substitute opioid treatment, using a cross-sectional study design, with 630 patients from three London community drug services. Adherence was measured as the number of doses collected from the pharmacy as a proportion of the total number of doses stipulated on the prescription during a 28-day period and was further investigated through laboratory urine drug screens. RESULTS: Overall, 30.5% (n = 191) of individuals failed to pick up at least one dose of medication from the pharmacy over 1 month, but only 1.6% (n = 10) missed 50% or more of their doses. Non-adherence was associated with supervised consumption, more frequent pick-up, shorter duration of treatment, younger age, a lower dose of methadone and a recent urinalysis result positive for opiates. CLINICAL IMPLICATIONS: Treatment services need to monitor levels of adherence to treatment and develop strategies to improve it so that treatment can be optimised effectively.