Department of Psychiatry, GMERS Medical College, Gotri, Vadodara 390021, India.
Centre for Mental Health Law and Policy, Indian Law Society, Pune, 411004, India.
Asian J Psychiatr. 2017 Aug;28:4-8. doi: 10.1016/j.ajp.2017.03.016. Epub 2017 Mar 19.
Dropout from an outpatient clinic is the loss of patient to the scheduled follow-up. Noncompliance in the form of treatment dropouts is a major problem across outpatient mental health settings and can range from 15% to 60%. Follow-up studies provide valuable insights into improving the quality of existing mental health facilities. Quality Rights Gujarat (QRG) is a step toward improving mental health facilities across various centers.
This retrospective observational study aims to explore follow-up pattern, predictors and any change after QRG implementation. Pre intervention Group (A) attended psychiatry OPD for 6 months before implementation of QRG project and Post intervention Group (B) attended psychiatry OPD for 3 months after implementation of QRG project.
Total 1632 Patients consulted in group A and 926 patients consulted Psychiatry OPD in group B. The most common Psychiatric disorder were Depression (A-19.55%, B-28.62%), Schizophrenia and related disorders (A-14.15%, B-15.01%), Neuropsychiatric disorders like headache and epilepsy (A-14.52%, B-18.68%), substance use disorder (A-15.26%, B-13.71%) and Bipolar disorder (A-11.76%, B-13.17%). 59.56% patients dropped out after the first visit in pre intervention group as compared to 51.94% patients in post intervention group. Significant reduction of about 8% in loss to follow up and 16% increase in follow-ups of initial visits after implementation of Quality Rights Gujarat project.
Much can be done to improve attendance in most services. The initiative like QRG significantly has positive results on patient's follow-up.
门诊病人流失是指病人未能按照预约进行随访。在门诊心理健康环境中，不遵守治疗规定（表现为治疗脱落）是一个主要问题，其比例范围为 15%至 60%。随访研究为改善现有心理健康设施的质量提供了有价值的见解。古吉拉特邦质量权利（QRG）是改善各个中心心理健康设施的一步。
本回顾性观察研究旨在探索随访模式、预测因素以及 QRG 实施后的任何变化。预干预组（A）在实施 QRG 项目前的 6 个月内参加精神病学门诊，干预后组（B）在实施 QRG 项目后 3 个月内参加精神病学门诊。
A 组共有 1632 名患者就诊，B 组有 926 名患者就诊于精神病学门诊。最常见的精神障碍是抑郁症（A-19.55%，B-28.62%）、精神分裂症及相关障碍（A-14.15%，B-15.01%）、神经精神障碍如头痛和癫痫（A-14.52%，B-18.68%）、物质使用障碍（A-15.26%，B-13.71%）和双相情感障碍（A-11.76%，B-13.17%）。在预干预组中，有 59.56%的患者在首次就诊后流失，而在干预后组中，有 51.94%的患者流失。实施古吉拉特邦质量权利项目后，失访率显著降低了约 8%，首次就诊的随访率增加了 16%。
在大多数服务中，还有很多工作要做，以提高出勤率。像 QRG 这样的举措对患者的随访有显著的积极影响。
