Predictors of Inpatient Treatment Completion and Non Completion in Patients with Alcohol Dependence from a Tertiary Care Centre in Central India

Abstract

Introduction: In India, millions of individuals are affected by alcohol dependence as evident by a recent national survey. Apart from the serious health consequences, the use of alcohol brings significant social and economic losses to individuals and society as well. The early treatment discontinuation for deaddiction of alcohol is a major challenge, therefore identification of predictors of treatment completion could be of use to reorganise treatment programs effectively. Aim: To study the predictors of inpatient treatment completion of subjects with alcohol dependence in the deaddiction ward of a tertiary care centre and to compare the socio-demographic and clinical variables among completers and non completers. Materials and Methods: The cross-sectional study was conducted at the Department of Psychiatry, MGM Medical College Indore, India. The convenient sample of 100 patients was recruited in a period of one year. Selected inpatients were assessed through semi-structured proforma consisting of socio-demographic variables, clinical variables, and clinical rating scales i.e., Severity of Alcohol Dependence Questionnaire (SADQ), Clinical Institute Withdrawal Assessment of Alcohol Scale (CIWA-Ar), and Readiness to Change Questionnaire (RCQ). CIWA and SADQ scores were compared with student’s t-test and RCQ categories were compared with Chi-square test. To identify the predictors of treatment completion, binary logistic regression analysis was used. Results: The mean age of participants was 36.5 years. All patients were male. The majority of the enrolled participants were urban 80 (80%) and 20 (20%) were rural. Binary logistic regression was performed to identify the predictors of treatment completion and non completion, so the treatment completers/non completers were taken as dependent variables and other socio-demographic/clinical variables as independent variables. The analysis showed that the education (p=0.01), occupation (p=0.01), history of substance in family (p=0.037) and complicated withdrawal (p=0.024) were the significant predictors in the study. Conclusion: The current study concludes that the education, occupation, history of substance in family, initiation of substance in younger age and complicated withdrawal, were the significant predictors of treatment completion in context of alcohol dependence. It was found that the stated readiness to change and treatment completion did not display a significantly positive correlation.

Keywords

• dropout
• relapse
• substance
• withdrawal