Predictors of Five-Year Readmission to an Inpatient Service among Patients with Alcohol Use Disorders: Report from a Low-Middle Income Country

Ghosh, Abhishek; Sharma, Nidhi; Noble, Dalton; Basu, Debasish; Mattoo, Surendra Kumar; Subodh, BN; Pillai, Renjith R

doi:10.1080/10826084.2021.1990341

Cited by 8 publications

(9 citation statements)

References 41 publications

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“…Similar results from large-scale longitudinal studies from the United Kingdom and United States, with varied programs and client-related factors, indicated that positive effects of treatment completion cut across countries and cultures 5,9,10 . The latter assumption was further supported by our recent study that showed a significantly reduced risk of readmission to inpatient care among clients who completed their first inpatient treatment 11 …”

supporting

confidence: 65%

“…5,9,10 The latter assumption was further supported by our recent study that showed a significantly reduced risk of readmission to inpatient care among clients who completed their first inpatient treatment. 11 Therefore, identifying the risk factors for early treatment discontinuation and conceiving programs and policies to address those risk factors may improve the rates of treatment completion and SUD outcomes. Previous research from the United States suggested that age, duration of substance use, type of withdrawal medications, and even psychosocial factors might influence the completion of inpatient treatment.…”

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confidence: 99%

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Predictors of Treatment Completion in an Inpatient Substance Use Treatment Service in India

et al. 2022

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Introduction: Treatment completion is associated with a better outcome in substance use disorders. We examined the rates of treatment completion and its predictors in patients admitted to specialized addiction treatment settings over a 13-year period. Methods: Ours was a retrospective cohort study. We included consecutive 2850 patients admitted to the inpatient treatment between January 2007 and December 2019. We divided the patients into 2 groups: completed versus premature discontinuation of treatment. The predictor variables were based on previous research, clinical experience, and availability of the digital record. Results: The number of patients who completed and discontinued treatments was 1873 (72.6%) and 707 (27.4%), respectively. The inpatient treatment discontinuation rate varied widely during the study period (18% in 2007 and 41% in 2012). The average rate of treatment discontinuation was 27%. The change-point analysis showed 5 statistically significant change points in the years 2008, 2010, 2012, 2014, and 2016. Patients who were prescribed medications for alcohol and opioid dependence and those who were on opioid agonist treatment had 4.7 and 6.3 higher odds of completing inpatient treatment than those who were not on medication. Patients with physical and psychiatric comorbidities had higher odds of treatment completion. Patients with a primary diagnosis of opioid dependence had lower odds of treatment completion than those with alcohol dependence. Conclusions: The rates of discontinuation may vary with concurrent changes in the treatment policies. Awareness of the risk factors and policy measures that may improve treatment completion must aid in informed decision making.

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confidence: 99%

Predictors of Treatment Completion in an Inpatient Substance Use Treatment Service in India

et al. 2022

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“…(2) treatment outcomes at discharge will be influenced by how long patients remain in treatment and their appointment attendance [34,42]; (3) treatment outcomes at discharge will be the primary explanatory factor for readmission to treatment [25,26]; and (4) a longer time spent in treatment will be associated with a decreased likelihood of readmission to treatment [27].…”

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confidence: 99%

Modeling the Therapeutic Process of Patients with Cocaine Use Disorders: A Guide for Predicting Readmission

Dacosta-Sánchez,

Fernández-Calderón,

Díaz-Batanero

et al. 2024

Eur Addict Res

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Introduction: Patients with cocaine use disorders have very high readmission rates. Our aim was to model the relationships between attributes of patients with cocaine use disorder at the beginning of treatment, therapeutic process indicators of time in treatment or proportion of appointments attended, and treatment outcomes, including outcomes at discharge and non-readmissions posttreatment as indicators of therapeutic success. Method: A retrospective observational design was used with 10,298 cocaine use disorder patients. Electronic health records were used for statistical analysis of the data. Randomized subsample 1 (n = 5,150) was used for exploratory analysis and subsample 2 (n = 5,148) for modeling relationships between the variables. Results: Patients attributes at intake (e.g., legal services as the source of referral) were of limited significance in explaining time in treatment, proportion of appointments attended, and treatment outcomes. Time in treatment and proportion of appointments attended emerged as significant factors in explaining outcomes at discharge. However, readmissions were primarily explained by time in treatment and outcomes at discharge, although referrals to addiction centers by health services also appeared to be relevant for explaining readmission. Discussion/Conclusion: Our study has shown that maintaining a sufficient appointment attendance rate and remaining in treatment for a longer duration are critical therapeutic process indicators for explaining outcomes at the point of discharge and therapeutic success, as indicated by a reduced likelihood of readmissions. Patients who remained in treatment for an extended period were found to have a reduced risk of future readmissions. In addition, our study highlights the importance of maintaining a satisfactory appointment attendance rate to attain successful short- and medium-term therapeutic discharge outcomes. These guidelines could help to increase the efficiency of patient treatment and alleviate the suffering of both patients and their families.

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“…For example, studies using large samples of patients with substance use disorders concerning various drugs [20][21][22] point to certain patient characteristics more strongly associated with readmission, such as the type of substance used (e.g., amphetamine), being female, having been arrested, or having comorbid mental disorders. Studies conducted exclusively with opiate use disorder patients [23,24] show that patients with greater post-treatment deterioration and certain sociodemographic characteristics and psychiatric comorbidities are more likely to require readmissions. Findings from authors who have studied patients with alcohol use disorder exclusively suggest that premature treatment dropout, psychiatric health problems, younger age, and longer duration of treatment are more strongly associated with readmission than other factors [25,26].…”

Section: Introductionmentioning

confidence: 99%

Modeling the Therapeutic Process of Patients with Cocaine Use Disorders: The Texas Christian University Process Model as a Guidance to Predict Readmission

Dacosta‐Sánchez

Fernández‐Calderón

Batanero

et al. 2023

Preprint

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Background: Patients readmitted for Cocaine Use Disorders are, along with Opiates Use Disorder, one of the group of patients with highest demand of treatment in specialized centers of addiction and with greater therapeutic failure. Objective: Our aim is to apply the Texas Christian University Process Model to modeling the relationships between patient's attributes at intake of treatment, treatment progress indicators and outcomes, including treatment success and readmissions. Method: A retrospective observational design was used with 10,298 Cocaine Use Disorder patients. Electronic health records were used for statistical analysis of the data. Randomized subsample 1 (n= 5,150) was used for exploratory analysis and subsample 2 (n = 5,148) to modeling variables relations. Results: Patients attributes at intake have limited relevance in explaining the treatment progress indicators and outcomes. Time on treatment and patient's adherence are relevant to explain treatment success. Readmissions are mainly explained by time in treatment and therapeutic success. Been referred to addiction centers by health of services also appear to be relevant. Discussion and conclusion: Our study reflects that the therapeutic process is important in order to have and adequate therapeutic adherence and to stay longer in treatment. Patients with a successful treatment and longer stay in treatment are less likely to have future readmissions. Through this study we highlight, therefore, the value of an adequate therapeutic adherence to obtain successful short- and medium-term results. This would make the treatment of these patients more efficient, and alleviate suffering for the patients and their families.

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Predictors of Five-Year Readmission to an Inpatient Service among Patients with Alcohol Use Disorders: Report from a Low-Middle Income Country

Cited by 8 publications

References 41 publications

Predictors of Treatment Completion in an Inpatient Substance Use Treatment Service in India

Predictors of Treatment Completion in an Inpatient Substance Use Treatment Service in India

Modeling the Therapeutic Process of Patients with Cocaine Use Disorders: A Guide for Predicting Readmission

Modeling the Therapeutic Process of Patients with Cocaine Use Disorders: The Texas Christian University Process Model as a Guidance to Predict Readmission

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