A Prospective Study in North Indian Psychiatric Outpatient Clinic; to Evaluate the Reasons of Drop Out in Newly Diagnosed Psychiatric Patient.

Abstract

Introduction

Drop out of new patients on follow up visit are frequently seen in outpatient psychiatric clinic. It is very important to explore the reason for dropout as it affects economy, manpower, patient health and treatment process.

Objective

To assess and evaluate the reason for drop out in newly diagnosed psychiatric patient at urban psychiatric outpatient clinic of north India.

Aim

To explore and establish relation between the common factor for continuing the treatment or switching to some alternative options of treatment.

Methods

The newly enrolled psychiatric patients with established diagnosis has been included in study over a period of one month and followed up for next six months on their given appointment dates. The patients were followed up by telephone, e-mail or personal visit to their home by a psychiatric social worker with specific set of questionnaires to evaluate the reason for drop out.

Results

180 newly diagnosed patients had been included in study in one month of inclusion period. 26 patients (14.4%) drop out the treatment after first visit. 14 patients (7.7%) dropped the treatment after second visit. Drop outs gradually decreased after every subsequent visit.

Conclusions

Maximum drop outs of patients were on first follow visit. There was gradual decrease in dropout rate after every subsequent visit. Trust, rapport, first dose effect, immediate response to patient query were most important factor to hold the patient in initial few visits. Later on, the old patients who had been already made 3-4 visits, dropped due to side effects, treatment response, economical factor, distance and timing of outpatient clinic.