Khan Jahangir, Khan Jwaad A, Kumari Subhra, Charan Deepak
Department of Healthcare and Pharmaceutical Management, School of Management and Business Studies, Jamia Hamdard, New Delhi, IND.
Department of Pathology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, IND.
Cureus. 2024 Feb 19;16(2):e54495. doi: 10.7759/cureus.54495. eCollection 2024 Feb.
The success of any medical intervention, including mental health treatment, depends largely on patient adherence to the prescribed regimen. In psychiatric illnesses, one of the biggest problems is getting people to adhere to their treatment schedule, representing a treatment gap that increases the burdens of patients, families, communities, and countries. Globally, it has become necessary for community health organizations to actively work towards reducing this gap and treatment non-adherence. Therefore, in this study, we aimed to examine treatment non-adherence patterns among patients with mental illness.
This work used a retrospective study design and consecutive sampling. The data source was secondary data obtained from the healthcare records of patients registered in the outpatient department of the District Mental Health Care Center, India, from January 2022 to December 2022.
Out of a total of 883 patients recruited for the study, 35.7% (n=315) were on regular follow-up over a duration of more than one year. Among patients with severe mental illness, 46% (n=46) had regular follow-ups and were compliant with therapy. About 49% of patients (n=433) discontinued their treatment after the initial contact with the therapist, with the highest rate among those with substance use disorders (77.0%; n=57). The remaining 15.3% (n=135) of recruited patients discontinued their follow-up appointments over a duration of 1 week to 12 months. Overall, 64.3% (n=568) of the recruited patients discontinued their treatment within one year.
There was considerable early treatment dropout among patients with mental illness. However, this treatment discontinuation can be avoided because the individual identities of these patients are well-known to the therapist or facility, as they have had at least one interaction with the therapist. In order to improve treatment adherence, patients with mental illnesses must receive consistent support through community outreach programs, home visits, and new strategies to promote treatment compliance.
任何医疗干预措施的成功，包括心理健康治疗，在很大程度上都取决于患者对规定治疗方案的依从性。在精神疾病中，最大的问题之一是让人们遵守治疗计划，这代表着一个治疗缺口，增加了患者、家庭、社区和国家的负担。在全球范围内，社区卫生组织积极致力于缩小这一缺口和治疗不依从性已变得十分必要。因此，在本研究中，我们旨在研究精神疾病患者的治疗不依从模式。
本研究采用回顾性研究设计和连续抽样方法。数据来源是从印度地区精神卫生保健中心门诊部2022年1月至2022年12月登记的患者医疗记录中获取的二手数据。
在总共招募的883名研究患者中，35.7%（n = 315）进行了为期一年以上的定期随访。在患有严重精神疾病的患者中，46%（n = 46）进行了定期随访并依从治疗。约49%的患者（n = 433）在初次与治疗师接触后停止治疗，其中物质使用障碍患者的停药率最高（77.0%；n = 57）。其余15.3%（n = 135）的招募患者在1周至12个月的时间内停止了随访预约。总体而言，64.3%（n = 568）的招募患者在一年内停止了治疗。
精神疾病患者中存在相当多的早期治疗中断情况。然而，这种治疗中断是可以避免的，因为治疗师或机构清楚了解这些患者的个人身份，因为他们至少与治疗师有过一次接触。为了提高治疗依从性，精神疾病患者必须通过社区外展项目、家访以及促进治疗依从性的新策略获得持续支持。
