A Retrospective Cohort Study to Assess the Long-term Retention and Outcome among Inpatients Admitted to a Tertiary Care Addiction Psychiatry Unit in India

Abstract

Background and Aims: Understanding the long-term outcomes of patients with substance use disorders can help to understand their course and prognosis. We aimed to find out the 10-year retention of patients who underwent short-term inpatient treatment at a tertiary care addiction psychiatry treatment facility. Methodology: This retrospective cohort study evaluated the medical records of patients who underwent short-term inpatient treatment in the year 2009 in an addiction treatment facility. The last year retention in treatment was ascertained at 1, 2, 5, and 10 years using case records. Attempt was made to contact the patients to assess their current status using telephonic interview. Results: Of the 572 patients included in the study, 40.9%, 24.7%, 10.5%, and 5.1% of the initial sample were retained at 1, 2, 5, and 10 years, respectively. Only 3.0% of the sample were retained in treatment continuously without dropping out even once. Several factors such as having a comorbid medical disorder, previous inpatient setting treatment, or routine planned discharge were associated with better retention in treatment at some time points. Of the 58 patients who could be contacted telephonically to assess the 10-year outcomes, a significant proportion (41.4%) was abstinent from all substances except tobacco. Among these patients who could be followed up (about 10% of the initial sample), the most common reason of not being in treatment was that they were abstinent from substances. Conclusion: Gradual attrition from treatment occurs over long-term time course among patients admitted with substance use disorders, though many re-enter treatment process.