Outpatient Addiction Treatment for Problematic Alcohol Use: What Makes Patients Who Dropped Out Different from Those Who Did Not?

ABSTRACT

Background: A minority of individuals with problematic alcohol use effectively seek help. Moreover, dropouts from care are not uncommon. It remains a major concern for health professionals, as adherence to treatment is significantly associated with better physical and psychological outcomes. Objectives: The main aim of this research was to assess what factors could distinguish patients with problematic alcohol use who dropped out from those who did not. Methods: The sample included 150 patients followed-up in an outpatient treatment center in France for a problematic alcohol use. Two measurement times were planned: at the first appointment and after six month of treatment. A large set of individual, environmental and institutional variables were considered to compare both subgroups. Results: Patients who dropped out mostly differ from patients who did not with a higher level of alcohol-related problems, ambivalence, inclinations to use the substance, number of missed appointments. Significant results were also observed regarding a lower time gap between the first contact with the center and the first appointment, as well as the season of the last appointment. Conclusions: Tailored motivational interventions could be offered to ambivalent patients, especially during the beginning of the treatment and some significant periods of the year. A particular focus should be brought on patients presenting such profiles in terms of level of alcohol problems, inclinations to drink and motivation to change. Overall, the study provides elements to better understand what may bring one patient to drop out of the treatment, and to improve the continuity of care.

KEYWORDS:

• Problematic alcohol use
• outpatients
• dropouts
• adherence to treatment
• retention

Acknowledgments

We would like to thank the staff of the Beauséjour Addiction Care, Support and Prevention Center (ACSPC) for their time, information and assistance during this research and its parent study (Project DECA). We would like to thank as well outpatients who agreed to participate.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Conflicts of interest and source of funding

None

Author contributions

Vincent Wagner conducted literature searches, statistical analysis and wrote the first draft of the manuscript. Didier Acier wrote the main research protocol and got its approval by the ethical research committee. Jean-Eric Dietlin co-designed the research protocol and coordinated the study in Beauséjour Addiction Care, Support and Prevention Center. All authors contributed to and have approved the final manuscript.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.