Background: In the last few years there seems to be an emerging interest for including the patients� perspective\r\nin assessing methadone maintenance treatment (MMT), with treatment satisfaction surveys being the most\r\ncommonly-used method of incorporating this point of view. The present study considers the perspective of\r\npatients on MMT when assessing the outcomes of this treatment, acknowledging the validity of this approach as\r\nan indicator. The primary aim of this study is to evaluate the concordance between improvement assessment\r\nperformed by two members of the clinical staff (a psychiatrist and a nurse) and assessment carried out by MMT\r\npatients themselves.\r\nMethod: Patients (n = 110) and their respective psychiatrist (n = 5) and nurse (n = 1) completed a scale for\r\nassessing how the patient�s condition had changed from the beginning of MMT, using the Patient Global\r\nImpression of Improvement scale (PGI-I) and the Clinical Global Impression of Improvement scale (CGI-I),\r\nrespectively.\r\nResults: The global improvement assessed by patients showed weak concordance with the assessments made by\r\nnurses (Quadratic-weighted kappa = 0.13, p > 0.05) and by psychiatrists (Quadratic-weighted kappa = 0.19, p =\r\n0.0086), although in the latter, concordance was statistically significant. The percentage of improved patients was\r\nsignificantly higher in the case of the assessments made by patients, compared with those made by nurses (90.9%\r\nvs. 80%, Z-statistic = 2.10, p = 0.0354) and by psychiatrists (90.9% vs. 50%, Z-statistic = 6.48, p < 0.0001).\r\nConclusions: MMT patients� perception of improvement shows low concordance with the clinical staff�s\r\nperspective. Assessment of MMT effectiveness should also focus on patient�s evaluation of the outcomes or\r\nchanges achieved, thus including indicators based on the patient�s experiences, provided that MMT aim is to be\r\nmore patient centred and to cover different needs of patients themselves.
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