Factors Associated With Attendance at a First Appointment After Discharge From a Psychiatric Hospital

Abstract

A retrospective review of medical records of 158 patients who were discharged from a university-affiliated psychiatric hospital in the Midwest found that 29 patients (18 percent) did not attend their scheduled follow-up appointment. Multivariate logistic regression analysis showed that patients who were white, who lived in an urban county, and whose scheduled appointment was within two weeks of discharge were significantly more likely to attend their follow-up appointment. The study showed that patients who have an elevated risk of missing their follow-up appointment after hospital discharge can be prospectively identified. This information can be used to develop strategies for improving the likelihood that at-risk patients will receive follow-up care.

Factors that Affect Adolescent Adherence to Mental Health and Psychiatric Treatment: a Systematic Integrative Review of the Literature

“…This type of treatment may influence the desire of adolescents to participate in the referred and prescribed regimens. For example, it has been suggested that more contact with mental health professionals improves treatment adherence among adolescents (44) and that better-scheduled appointments increase adherence (8). This suggestion is in line with the findings of this systematic review, in which adolescent's own will to undergo treatment was found to be one key factor that supported adherence.…”

“…Furthermore, the term service engagement can be defined as a multifactorial process that involves the acceptance of treatment and collaboration with a shared goal of recovery (12). The period between discharge from inpatient care and engagement with follow-up treatment is especially critical; it is also a vulnerable time for patients with mental illness who require long-term care (8). Especially among adolescents, more information is needed to understand the factors that contribute to readmission (13).…”

Attendance at an outpatient follow-up clinic by HIV-positive psychiatric patients initiated on ART as inpatients

“…[11] The rate of attendance found at our integrated clinic is comparable with rates of first clinic appointment attendance post discharge from psychiatric hospitalisation internationally. [13,14] There are no data with which to compare our rate of attendance with early attendance post hospitalisation at HIV treatment centres in order to evaluate the effectiveness of the integrated model in terms of improving outcomes.…”

“…Factors found to be associated with clinic attendance at ART clinics and at mental health clinics have generally been inconsistent but include a variety of sociodemographic and clinical factors. [13][14][15][16] Patients LTFU at the Luthando Clinic in a previous study cited logistical and financial reasons for clinic non-attendance, as well as miscommunication concerning the follow-up appointment date. [12] A larger evidence base regarding the prescription of ART in the mentally ill, subsequent follow-up, adherence to ART regimens and long-term retention in care after inpatient initiation of ART in the mentally ill will hopefully help guide future research and tailor treatment guidelines to better serve this potentially vulnerable population.…”

“…First clinic appointment attendance post discharge from hospitalisation has previously been studied internationally in the psychiatric setting, with non-attendance ranging from 18% to 64%. [13,14] To our knowledge, this has not been directly studied in an integrated HIV and mental healthcare centre, or in a South African (SA) setting. Factors found to be associated with clinic attendance at ART clinics and at mental health clinics have generally been inconsistent but include a variety of sociodemographic and clinical factors.…”