Dropout of drug addicts treatment: prevalence and associated factors identified from the active surveillance of patients

Abstract Introduction Drug addiction is considered a heterogeneous etiology disorder, there are guidelines for their treatment, but still there is a high drop out rate. The research has the purpose to identify the prevalence and associated factors to the abandonment of the treatment. Methods Cross-sectional study, with a review of 593 medical records and 30 interviews applied to patients who had not adhered to treatment in a substance abuse clinic in a municipality located in southern Rio Grande do Sul. Results The dropout rate was 82%. The treatment time (Coef = –0.14, SE = 0.08; OR = 0.9), treatment with the social worker (Coef = –0.68, SE = 0.33, OR = 0.5) and psychological treatment (Coef = –0.66, SE = 0.44, OR = 0.5) decreased to the likelihood of abandonment. The most frequently reported reason in the interviews to justify the abandonment was the service’s opening hours coinciding with working hours (33%, n = 10). Conclusion It is necessary to pay attention to the evasion phenomenon in order to provide alternatives to increasing compliance and the return of these patients.

摘要 引言：药物成瘾被视为一类异质性病因障碍，尽管已有针对该病的治疗指南，但患者治疗脱落率仍居高不下。本研究旨在明确物质滥用治疗脱落的患病率及相关影响因素。方法：本研究为横断面研究，回顾了巴西南里奥格兰德州南部某市镇物质滥用诊所的593份病历，并对其中未坚持治疗的患者开展30次访谈。结果：本次研究的患者治疗脱落率为82%。分析显示，治疗时长（回归系数=-0.14，标准误（Standard Error，SE）=0.08；优势比（Odds Ratio，OR）=0.9）、社会工作者干预治疗（回归系数=-0.68，标准误SE=0.33；优势比OR=0.5）以及心理治疗（回归系数=-0.66，标准误SE=0.44；优势比OR=0.5）可降低治疗脱落风险。访谈中最常被提及的脱落原因为门诊开诊时间与患者工作时间重合，占比33%（n=10）。结论：需重视治疗脱失现象，为提升患者治疗依从性及促使其返院治疗提供可行替代方案。