Higher dropout rate in non-native patients than in native patients in rehabilitation in The Netherlands

Abstract

Dropout from a rehabilitation programme often occurs in patients with chronic nonspecific low back pain of non-native origin. However, the exact dropout rate is not known. The objective of this study was to determine the difference in dropout rate between native and non-native patients with chronic nonspecific low back pain participating in a rehabilitation programme in The Netherlands. A retrospective study (n = 529) of patient files was performed in two rehabilitation centres and two rehabilitation departments of general hospitals in The Netherlands. Patient files were checked for diagnosis, status of origin, sex, age and outcome, that is, reason for finishing treatment. The difference in dropout rate between patients of Dutch and non-Dutch origin was tested by chi tests and logistic regression-analysis, controlling for age, sex, type of rehabilitation institute and phase of the rehabilitation programme. Dropout occurred among one fifth (18.7%) of the total patient population. Dropout among patients of non-Dutch origin was twice as high as among native Dutch patients (P < 0.001). In regression analyses dropout was related to status of non-Dutch origin, treatment in a rehabilitation centre and the diagnostic phase of a rehabilitation programme. In conclusion, patients of non-Dutch origin drop out considerably more frequently than native Dutch patients. Dropout is higher in the diagnostic phase than in the treatment phase and in rehabilitation centres than in hospitals. Future research should clarify the reasons for the high dropout rate in patients of non-native origin.

Predictors of dropout in interdisciplinary chronic pain management programmes: A systematic review

“…Seven studies described outpatient chronic pain management programmes with an interdisciplinary approach (27,29,(31)(32)(33). Three of these studies were outpatient programmes with a focus on return to work, known as functional restoration programmes (24,27,29).…”

“…Four studies included patients with chronic low back pain only (27,29,32,33), the other 4 studies included patients with chronic pain in various parts of the body (24,28,30,31). One study conducted a thorough investigation of predictors of dropout with multiple logistic regression analyses in a group of 300 (16%) dropouts from a total sample of 1,845 patients (16%) (24).…”

“…One study conducted a thorough investigation of predictors of dropout with multiple logistic regression analyses in a group of 300 (16%) dropouts from a total sample of 1,845 patients (16%) (24). In 6 studies the dropout group varied from 14 (23%) to 685 patients (16%) (24,33) and in 2 studies it was unclear how many dropouts were investigated (29,32). There were no important differences in sex and in age between 5 of the studies.…”

First rehabilitation consultation in patients of non-native origin: Factors that lead to tension in the patient–physician interaction

“…Previous studies in patients with chronic (low back) pain who participated in a rehabilitation programme found drop-out rates ranging from 10-42% [4][5][6]. Drop-out from chronic low back pain rehabilitation treatment in non-native patients (28.1%) in The Netherlands has been reported to be twice as high as in native Dutch patients (13.7%) [7]. There is limited knowledge of the causes of this higher drop-out.…”

Adaptations to pain rehabilitation programmes for non-native patients with chronic pain

“…Drop-out from low back pain rehabilitation programmes in The Netherlands has been shown to be twice as high in non-native patients (28.1%) compared to native Dutch patients (13.7%) [1]. Nonnative patients more frequently than native patients dropped out because they had different expectations than the treating health professionals regarding the content of their rehabilitation programme.…”