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Evaluation of factors associated with psychiatric patient dropout at a university outpatient clinic in Japan

View Article: PubMed Central - PubMed

ABSTRACT

Background: Patient dropout from treatment can lead to a deterioration in clinical condition, thereby increasing the need for more intensive therapy that incurs substantial social and economic losses. The aim of this study was to identify factors related to psychiatric patient dropout at a university outpatient clinic in Japan.

Methods: We retrospectively examined the medical charts of new psychiatric patients who were diagnosed with either a mood disorder (International Classification of Diseases, 10th revision, code: F3) or an anxiety disorder (F4) in the outpatient clinic at Kyoto Prefectural University of Medicine Hospital in Kyoto, Japan, between April 2010 and March 2013. The baseline characteristics of the patients (age, sex, Global Assessment of Functioning score, Clinical Global Impression–Severity of Illness score, education, occupation, marital status, duration of treatment, and prior treatment history), treating psychiatrist experience in years, and sex concordance between the patients and their treating psychiatrists were analyzed using Cox regression models.

Results: From among 1,626 eligible new patients during the study period, 532 patients were enrolled in the study (F3: n=176; F4: n=356). The dropout rate was 35.7%, which was similar to that of previous studies. Higher educational level, being married, and lower Global Assessment of Functioning scores were associated with a lower dropout rate. Although psychiatrist experience was not significantly associated with patient dropout in the multivariate analysis, patients treated by less experienced psychiatrists had a higher hazard ratio for dropout (1.31; 95% confidence interval: 0.94–1.85).

Conclusion: In order to reduce the dropout rate, special focus should be placed on patients with the factors identified in this study, and young psychiatrists should undergo further education to foster adherence.

No MeSH data available.


Proportion of continuing patients according to the treating psychiatrists’ experience in years.
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f2-ppa-10-1903: Proportion of continuing patients according to the treating psychiatrists’ experience in years.

Mentions: Table 3 shows the results of the Cox regression analyses. The univariate analyses identified educational level, GAF score, and psychiatrist experience to be significantly associated with patient dropout. In the multivariate analysis, patient age, educational level, marital status, and GAF score were found to be significantly associated with patient dropout. Although psychiatrist experience was not significantly associated with patient dropout in the multivariate analysis, the hazard ratio was 1.31 (95% confidence interval: 0.94–1.85) in patients treated by psychiatrists with fewer than 10 years of experience. Similarly, the Kaplan–Meier curves in Figure 2 show that patients treated by less experienced psychiatrists had a higher rate of dropout than those treated by psychiatrists with 10 years or more of experience.


Evaluation of factors associated with psychiatric patient dropout at a university outpatient clinic in Japan
Proportion of continuing patients according to the treating psychiatrists’ experience in years.
© Copyright Policy
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5036564&req=5

f2-ppa-10-1903: Proportion of continuing patients according to the treating psychiatrists’ experience in years.
Mentions: Table 3 shows the results of the Cox regression analyses. The univariate analyses identified educational level, GAF score, and psychiatrist experience to be significantly associated with patient dropout. In the multivariate analysis, patient age, educational level, marital status, and GAF score were found to be significantly associated with patient dropout. Although psychiatrist experience was not significantly associated with patient dropout in the multivariate analysis, the hazard ratio was 1.31 (95% confidence interval: 0.94–1.85) in patients treated by psychiatrists with fewer than 10 years of experience. Similarly, the Kaplan–Meier curves in Figure 2 show that patients treated by less experienced psychiatrists had a higher rate of dropout than those treated by psychiatrists with 10 years or more of experience.

View Article: PubMed Central - PubMed

ABSTRACT

Background: Patient dropout from treatment can lead to a deterioration in clinical condition, thereby increasing the need for more intensive therapy that incurs substantial social and economic losses. The aim of this study was to identify factors related to psychiatric patient dropout at a university outpatient clinic in Japan.

Methods: We retrospectively examined the medical charts of new psychiatric patients who were diagnosed with either a mood disorder (International Classification of Diseases, 10th revision, code: F3) or an anxiety disorder (F4) in the outpatient clinic at Kyoto Prefectural University of Medicine Hospital in Kyoto, Japan, between April 2010 and March 2013. The baseline characteristics of the patients (age, sex, Global Assessment of Functioning score, Clinical Global Impression–Severity of Illness score, education, occupation, marital status, duration of treatment, and prior treatment history), treating psychiatrist experience in years, and sex concordance between the patients and their treating psychiatrists were analyzed using Cox regression models.

Results: From among 1,626 eligible new patients during the study period, 532 patients were enrolled in the study (F3: n=176; F4: n=356). The dropout rate was 35.7%, which was similar to that of previous studies. Higher educational level, being married, and lower Global Assessment of Functioning scores were associated with a lower dropout rate. Although psychiatrist experience was not significantly associated with patient dropout in the multivariate analysis, patients treated by less experienced psychiatrists had a higher hazard ratio for dropout (1.31; 95% confidence interval: 0.94–1.85).

Conclusion: In order to reduce the dropout rate, special focus should be placed on patients with the factors identified in this study, and young psychiatrists should undergo further education to foster adherence.

No MeSH data available.