Factors Associated With Noncompliance With Psychiatric Outpatient Visits

Harvard University, Cambridge, Massachusetts, United States
Psychiatric Services (Impact Factor: 1.99). 04/2001; 52(3):378-80. DOI: 10.1176/
Source: PubMed

ABSTRACT Adherence to recommended services is essential for long-term effectiveness of ambulatory treatment programs, but factors associated with such adherence are not securely established. We evaluated attendance at 896 scheduled psychiatric clinic visits for 62 patients at a major psychiatric teaching hospital. Visit adherence was found to be significantly higher among patients in an acute stage of illness, those with a personality disorder, those with a post-high-school education, and those living alone. Adherence was also higher when visits were routinely scheduled, when the intervisit interval was shorter, and when the visit entailed psychotherapy rather than pharmacotherapy.

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    ABSTRACT: Non-compliance with pharmacotherapy among persons suffering from schizophrenia disorders stands at an average rate of 42% and is the subject of numerous studies. However, no studies to date have addressed the specific question of non-compliance with psychosocial treatment. The present study therefore aimed to determine the rate of drop-out from psychosocial treatment and to assess the influence of factors on this rate. A meta-analysis was conducted based on 74 studies of randomized clinical trials on psychosocial treatment among persons suffering from schizophrenia spectrum disorder. A drop-out rate of 13% was obtained. Age, gender, duration of illness, duration of treatment, treatment setting and study quality affected drop-out rates. The 13% rate of drop-out from psychosocial treatment is markedly lower than the drop-out rate from pharmacotherapy studies. This finding supports the feasibility of evidence-based psychosocial treatment - which has, moreover, clearly been shown to be clinically effective - as part of a complete care program for schizophrenia.
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