Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #106982

Bernard Cerutti, PhD¹, Ignazio Cassis, MD, MPH¹, and Barbara Broers, MD². (1) Department of Public Health and Social Welfare, via Dogana 16, Bellinzona, 6501, Switzerland, +41 91 814 40 09, bernard.cerutti@ti.ch, (2) Geneva University Hospital, 24 rue Micheli-du-Crest, Geneva, 1211, Switzerland

BACKGROUND: There is a large regional heterogeneity of the settings of maintenance treatment for opioid users in Switzerland. In some cantons, such as Ticino, only methadone prescribed by family physicians is available, while in other cantons, such as Geneva, different substances are prescribed by family physicians and specialized centers. OBJECTIVE: To evaluate the effectiveness of maintenance treatments in two regions with different health care structures. METHODS: A 3.5 year follow-up study of all maintenance treatments was carried out in Ticino and Geneva (n=3284 patients). Physicians are required by law to regularly update their Health Officer about the situation of their patients. Administrative public health data regarding the main treatment facts were thus analyzed. RESULTS: Shifts in treatment provider were more frequent in Geneva. For those stopping a treatment, the average duration was around 28 months. The parallel intake of heroin and cannabis was higher in Ticino, while cocaine was more frequently used in Geneva. The median methadone dosage was higher in Geneva, even among the family physicians. Finally, several significant predictive factors for the retention into treatment were identified. CONCLUSION: This study was a rare opportunity to evaluate on a large scale the practical impact of the guidelines derived from research, the medical practice, and the coverage of the target population. No fundamental intrinsic differences between the two regions were identified. The "effectiveness" of maintenance treatment in primary care settings is confirmed, but continuous education of the family physicians should be encouraged to increase congruence with current guidelines.

Learning Objectives:

• After attending the presentation or reading the poster, the participant will be able to define a short list of indicators used to assess a maintenance treatment policy, list some positive or negative predictive factors for the retention into treatment, identify some difference between an organization based on both family physicians and specialized centers and a system that relies on family physicians only.

Keywords: Drug Abuse Treatment, Methadone Maintenance

Related Web page: www.ti.ch/DSS/DSP/UffMC/settori/DIPENDENZE/

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Handout (.PDF format,