Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain.
Research Center on Natural Resources, Health and the Environment, University of Huelva, Huelva, Spain.
Eur Addict Res. 2024;30(2):80-93. doi: 10.1159/000535689. Epub 2024 Mar 4.
Patients with cocaine use disorders have very high readmission rates. Our aim was to model the relationships between attributes of patients with cocaine use disorder at the beginning of treatment, therapeutic process indicators of time in treatment or proportion of appointments attended, and treatment outcomes, including outcomes at discharge and non-readmissions posttreatment as indicators of therapeutic success.
A retrospective observational design was used with 10,298 cocaine use disorder patients. Electronic health records were used for statistical analysis of the data. Randomized subsample 1 (n = 5,150) was used for exploratory analysis and subsample 2 (n = 5,148) for modeling relationships between the variables.
Patients attributes at intake (e.g., legal services as the source of referral) were of limited significance in explaining time in treatment, proportion of appointments attended, and treatment outcomes. Time in treatment and proportion of appointments attended emerged as significant factors in explaining outcomes at discharge. However, readmissions were primarily explained by time in treatment and outcomes at discharge, although referrals to addiction centers by health services also appeared to be relevant for explaining readmission.
DISCUSSION/CONCLUSION: Our study has shown that maintaining a sufficient appointment attendance rate and remaining in treatment for a longer duration are critical therapeutic process indicators for explaining outcomes at the point of discharge and therapeutic success, as indicated by a reduced likelihood of readmissions. Patients who remained in treatment for an extended period were found to have a reduced risk of future readmissions. In addition, our study highlights the importance of maintaining a satisfactory appointment attendance rate to attain successful short- and medium-term therapeutic discharge outcomes. These guidelines could help to increase the efficiency of patient treatment and alleviate the suffering of both patients and their families.
患有可卡因使用障碍的患者的再入院率非常高。我们的目的是建立模型，分析治疗开始时患有可卡因使用障碍患者的特征、治疗过程中的时间指标（如治疗时间或就诊比例）与治疗结果（包括出院时的结果和治疗后非再入院情况，作为治疗成功的指标）之间的关系。
采用回顾性观察设计，纳入 10298 例可卡因使用障碍患者。使用电子健康记录对数据进行统计分析。随机抽取 1 个样本（n=5150）进行探索性分析，抽取另 1 个样本（n=5148）进行变量间关系建模。
患者入院时的特征（例如，法律服务作为转介来源）对解释治疗时间、就诊比例和治疗结果的意义有限。治疗时间和就诊比例是解释出院时结果的重要因素。然而，再入院主要由治疗时间和出院时的结果来解释，尽管卫生服务机构将患者转介到成瘾治疗中心似乎也与再入院的解释有关。
讨论/结论：我们的研究表明，保持足够的就诊出勤率和延长治疗时间是解释出院时结果和治疗成功的关键治疗过程指标，这表明降低再入院的可能性。延长治疗时间的患者被发现未来再入院的风险降低。此外，我们的研究强调了保持令人满意的就诊出勤率以实现短期和中期治疗出院结果成功的重要性。这些指导原则有助于提高患者治疗效率，减轻患者及其家属的痛苦。
