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Stratifying delays for assessment by type of substance to improve the probability of attendance in outpatient services
Abstract : 1) To confirm the association between delay for assessment (DFA) and probability of first-time attendance in outpatient substance use disorder (SUD) treatment. 2) To evaluate whether this association varies by the type of primary substance for which the assessment was requested. 3) To assess the possibility of estimating differential DFAs to conform to equal probabilities of attendance across various types of primary substance.
A prospective observational cohort of consecutive patients (N=1015) who requested a first-time assessment appointment at a publicly funded outpatient SUD treatment center in France between January 2014 and December 2015 was conducted. Logistic regression analyses were performed to evaluate associations between DFA (after log-transformation) and attendance and to provide estimates of attendance probability over time by the type of primary substance.
After adjusting for gender, age and referral status, the attendance rate was observed to decrease significantly with longer DFA (OR=0.54; 95%CI: 0.44-0.66). The strength of this association differed across types of primary substance (p for heterogeneity <0.0001), with the strongest association being found for opioids (adjusted OR=0.21; 95%CI: 0.10-0.45). DFA was also associated with attendance for alcohol (OR=0.51; 95%CI: 0.37-0.71) and cannabis (OR=0.60; 95%CI: 0.37-0.96), but not for tobacco (OR=0.95; 95%CI: 0.60-1.50). Differential DFAs reflecting equal probabilities of attendance across types of substance could be estimated.
Our study suggests that the approach of stratifying DFAs by the type of primary substance could be helpful to improve the probability of first-time attendance in outpatient SUD treatment services.
Keywords :
Outpatient services
Delays for assessment
First-time attendance to treatment
Substance misuse
Substance use disorders
Mesh:Alcoholism/psychology*
Mesh:Marijuana Abuse/psychology*
Mesh:Male
Mesh:Humans
Mesh:Female
Mesh:Middle Aged
Mesh:Opioid-Related Disorders/psychology*
Mesh:Opioid-Related Disorders/rehabilitation*
Mesh:Patient Compliance/psychology*
Mesh:Patient Outcome Assessment*
Mesh:Prospective Studies
Mesh:Smoking Cessation/methods*
Mesh:Central Nervous System Stimulants*
Mesh:Ambulatory Care*
Mesh:Alcoholism/rehabilitation*
Mesh:Smoking Cessation/psychology*
Mesh:Street Drugs*
Mesh:Substance-Related Disorders/psychology*
Mesh:Substance-Related Disorders/rehabilitation*
Mesh:Waiting Lists*
Mesh:Young Adult
Mesh:Adult
Mesh:Marijuana Abuse/rehabilitation*
https://hal.univ-lille.fr/hal-02549179
Contributeur : Lilloa Université de Lille <>
Soumis le : mardi 21 avril 2020 - 11:40:18
Dernière modification le : mercredi 22 avril 2020 - 01:44:28
Contributeur : Lilloa Université de Lille <>
Soumis le : mardi 21 avril 2020 - 11:40:18
Dernière modification le : mercredi 22 avril 2020 - 01:44:28
