Impact of Quality Rights Gujarat program on dropout rate of patients visiting outpatient psychiatry department of tertiary care hospital

Asian J Psychiatr. 2017 Aug:28:4-8. doi: 10.1016/j.ajp.2017.03.016. Epub 2017 Mar 19.

Abstract

Background: Dropout from an outpatient clinic is the loss of patient to the scheduled follow-up. Noncompliance in the form of treatment dropouts is a major problem across outpatient mental health settings and can range from 15% to 60%. Follow-up studies provide valuable insights into improving the quality of existing mental health facilities. Quality Rights Gujarat (QRG) is a step toward improving mental health facilities across various centers.

Methods: This retrospective observational study aims to explore follow-up pattern, predictors and any change after QRG implementation. Pre intervention Group (A) attended psychiatry OPD for 6 months before implementation of QRG project and Post intervention Group (B) attended psychiatry OPD for 3 months after implementation of QRG project.

Results: Total 1632 Patients consulted in group A and 926 patients consulted Psychiatry OPD in group B. The most common Psychiatric disorder were Depression (A-19.55%, B-28.62%), Schizophrenia and related disorders (A-14.15%, B-15.01%), Neuropsychiatric disorders like headache and epilepsy (A-14.52%, B-18.68%), substance use disorder (A-15.26%, B-13.71%) and Bipolar disorder (A-11.76%, B-13.17%). 59.56% patients dropped out after the first visit in pre intervention group as compared to 51.94% patients in post intervention group. Significant reduction of about 8% in loss to follow up and 16% increase in follow-ups of initial visits after implementation of Quality Rights Gujarat project.

Conclusions: Much can be done to improve attendance in most services. The initiative like QRG significantly has positive results on patient's follow-up.

Keywords: Follow up; Psychiatry outpatients; Quality Rights Gujarat; Treatment dropout.

MeSH terms

  • Adult
  • Female
  • Humans
  • India
  • Male
  • Mental Disorders / therapy*
  • Outcome Assessment, Health Care*
  • Outpatients*
  • Patient Dropouts*
  • Patient Rights / standards*
  • Program Development*
  • Psychiatric Department, Hospital
  • Quality Improvement / standards*
  • Tertiary Care Centers