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Determinants of dropout in a community-based mental health crisis centre.

Henzen A, Moeglin C, Giannakopoulos P, Sentissi O - BMC Psychiatry (2016)

Bottom Line: Among care-related variables, referral by hospital units or private psychiatrists led to significantly lower levels of dropout compared to patients referred by the psychiatric emergency unit (respectively: OR = .32; p = .04; 95% CI [.10, .93]; OR = .36; p = .04; 95% CI [.13, .96]; OR = .22; p = .002; 95% CI [.08, .58]).This study makes clear the need for increased efforts to improve care adherence in young patients with anxious or personality disorders seen in emergency rooms because they are prone to early discontinuation of treatments.Future studies in this field are warranted to gain a better understanding into the complex reasons that surround discontinuation of care in outpatient settings.

View Article: PubMed Central - PubMed

Affiliation: Mental Health and Psychiatry Department, University Hospitals of Geneva, CAPPI Jonction: 35, rue des Bains, 1205, Geneva, Switzerland.

ABSTRACT

Background: Dropping out during the course of medical follow up is defined as an early therapy withdrawal without the agreement of the therapist. In a psychiatric crisis unit in Geneva, we empirically observed that almost 50% of the patients were not showing up to their first appointments, which were scheduled for 3 to 7 days post discharge.

Methods: The aim of this naturalistic descriptive cohort study is to identify the demographic, patient and care-related predictive factors of dropout in a community-based psychiatric crisis centre. We included 245 consecutive outpatients followed-up for 4 to 6 weeks of intensive outpatient psychiatric treatment. Logistic regression models were built to examine the association between dropout and demographic, care and patient-related variables.

Results: Among the 245 outpatients, dropout occurred in 37.5% of cases, and it most frequently occurred (81.8%) in the first 2 days of follow-up. Among care-related variables, referral by hospital units or private psychiatrists led to significantly lower levels of dropout compared to patients referred by the psychiatric emergency unit (respectively: OR = .32; p = .04; 95% CI [.10, .93]; OR = .36; p = .04; 95% CI [.13, .96]; OR = .22; p = .002; 95% CI [.08, .58]). Among patient-related variables, younger age increased the risk of dropout (OR = .96; 95%; p = .002; 95% CI [.94, .99]). Anxiety and personality but not mood disorders were also related to higher rates of dropout (respectively: OR = 2.40; p = .02; 95% CI [1.14, 4.99]; and OR = 1.98; p = .02; 95% CI [1.09, 3.59]). Unipolar depression (72.2%; OR = 1.47; p = .48; 95% CI [.34, 1.21]) was the most frequent primary diagnosis in this sample.

Conclusions: This study makes clear the need for increased efforts to improve care adherence in young patients with anxious or personality disorders seen in emergency rooms because they are prone to early discontinuation of treatments. Future studies in this field are warranted to gain a better understanding into the complex reasons that surround discontinuation of care in outpatient settings.

No MeSH data available.


Related in: MedlinePlus

Characteristics of patients (N = 245) concerning initial and secondary dropout, and the day the dropout occurred. Legend: Initial dropout: initial non-attendance for the first scheduled appointment. Secondary dropout: care discontinuation after the first or the second consultation
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Fig1: Characteristics of patients (N = 245) concerning initial and secondary dropout, and the day the dropout occurred. Legend: Initial dropout: initial non-attendance for the first scheduled appointment. Secondary dropout: care discontinuation after the first or the second consultation

Mentions: Dropout occurred in 37.5 % of cases and most frequently (81.8 %) within the first 2 days of follow-up (secondary dropout, see Fig. 1). There were no statistically significant differences in the main demographic, care-related and patient-related variables between initial and secondary dropout groups.Fig. 1


Determinants of dropout in a community-based mental health crisis centre.

Henzen A, Moeglin C, Giannakopoulos P, Sentissi O - BMC Psychiatry (2016)

Characteristics of patients (N = 245) concerning initial and secondary dropout, and the day the dropout occurred. Legend: Initial dropout: initial non-attendance for the first scheduled appointment. Secondary dropout: care discontinuation after the first or the second consultation
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4837516&req=5

Fig1: Characteristics of patients (N = 245) concerning initial and secondary dropout, and the day the dropout occurred. Legend: Initial dropout: initial non-attendance for the first scheduled appointment. Secondary dropout: care discontinuation after the first or the second consultation
Mentions: Dropout occurred in 37.5 % of cases and most frequently (81.8 %) within the first 2 days of follow-up (secondary dropout, see Fig. 1). There were no statistically significant differences in the main demographic, care-related and patient-related variables between initial and secondary dropout groups.Fig. 1

Bottom Line: Among care-related variables, referral by hospital units or private psychiatrists led to significantly lower levels of dropout compared to patients referred by the psychiatric emergency unit (respectively: OR = .32; p = .04; 95% CI [.10, .93]; OR = .36; p = .04; 95% CI [.13, .96]; OR = .22; p = .002; 95% CI [.08, .58]).This study makes clear the need for increased efforts to improve care adherence in young patients with anxious or personality disorders seen in emergency rooms because they are prone to early discontinuation of treatments.Future studies in this field are warranted to gain a better understanding into the complex reasons that surround discontinuation of care in outpatient settings.

View Article: PubMed Central - PubMed

Affiliation: Mental Health and Psychiatry Department, University Hospitals of Geneva, CAPPI Jonction: 35, rue des Bains, 1205, Geneva, Switzerland.

ABSTRACT

Background: Dropping out during the course of medical follow up is defined as an early therapy withdrawal without the agreement of the therapist. In a psychiatric crisis unit in Geneva, we empirically observed that almost 50% of the patients were not showing up to their first appointments, which were scheduled for 3 to 7 days post discharge.

Methods: The aim of this naturalistic descriptive cohort study is to identify the demographic, patient and care-related predictive factors of dropout in a community-based psychiatric crisis centre. We included 245 consecutive outpatients followed-up for 4 to 6 weeks of intensive outpatient psychiatric treatment. Logistic regression models were built to examine the association between dropout and demographic, care and patient-related variables.

Results: Among the 245 outpatients, dropout occurred in 37.5% of cases, and it most frequently occurred (81.8%) in the first 2 days of follow-up. Among care-related variables, referral by hospital units or private psychiatrists led to significantly lower levels of dropout compared to patients referred by the psychiatric emergency unit (respectively: OR = .32; p = .04; 95% CI [.10, .93]; OR = .36; p = .04; 95% CI [.13, .96]; OR = .22; p = .002; 95% CI [.08, .58]). Among patient-related variables, younger age increased the risk of dropout (OR = .96; 95%; p = .002; 95% CI [.94, .99]). Anxiety and personality but not mood disorders were also related to higher rates of dropout (respectively: OR = 2.40; p = .02; 95% CI [1.14, 4.99]; and OR = 1.98; p = .02; 95% CI [1.09, 3.59]). Unipolar depression (72.2%; OR = 1.47; p = .48; 95% CI [.34, 1.21]) was the most frequent primary diagnosis in this sample.

Conclusions: This study makes clear the need for increased efforts to improve care adherence in young patients with anxious or personality disorders seen in emergency rooms because they are prone to early discontinuation of treatments. Future studies in this field are warranted to gain a better understanding into the complex reasons that surround discontinuation of care in outpatient settings.

No MeSH data available.


Related in: MedlinePlus