Original Research
Factors associated with dropout at 2 years post-initiation of treatment in the first episode of schizophrenia
Submitted: 12 November 2020 | Published: 09 March 2021
About the author(s)
Jebril M. Benelmokhtar, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South AfricaBonginkosi Chiliza, Department of Psychiatry, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
Lebogang Phahladira, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Robin Emsley, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Laila Asmal, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Abstract
Aim: The aim of this study was to examine clinical and sociodemographic factors associated with patient dropout in patients with FES.
Setting: This study was set at inpatient and outpatient services at a psychiatric hospital in the Western Cape, between 2007 and 2011.
Methods: Data were collected as part of a prospective longitudinal study, which followed up patients with FES treated with flupenthixol decanoate. We examined the relationship between treatment adherence and sociodemographic and clinical factors at baseline and at 24 months. Unadjusted and adjusted logistic regression models were used to determine adherence variables.
Results: A total of 62% of patients completed the 24 months of treatment. Participants with FES and a substance use disorder (dual diagnosis) were at greater risk of dropout (p = 0.01). On univariate analysis, dual diagnosis participants who dropped out were older (p = 0.04) had completed more years of schooling (p = 0.001), older age of onset (p = 0.02) and higher baseline positive symptoms (p = 0.05). On regression analysis, non-completer substance users achieved a higher level of education (odds ratio [OR]: 3.87, confidence interval [CI]: 1.34–11.11, p = 0.01).
Conclusion: Substance use disorder was associated with non-adherence to follow up in a cohort of FES patients treated with flupenthixol decanoate. Interventions that take into account age, education and baseline positive symptoms may afford the opportunity to influence adherence and patient outcome.
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Crossref Citations
1. Experiences of schizophrenia patients with treatment buddy support during the COVID-19 pandemic
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