Predictors of discharges against medical advice from a short-term hospital detoxification unit

• Published in: Drug and alcohol dependence Vol. 56; no. 1; pp. 1 - 8
• Main Authors: Armenian, Saro H, Chutuape, Mary Ann, Stitzer, Maxine L
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 02-08-1999; Elsevier Science
• Subjects: Adult; Against medical advice; Age Factors; Alcoholism - drug therapy; Alcoholism - urine; Biological and medical sciences; Case-Control Studies; Clonidine; Cocaine-Related Disorders - drug therapy; Cocaine-Related Disorders - urine; Detoxification; Diazepam; Discharge against medical advice; Drug abuse; Female; Heroin Dependence - drug therapy; Heroin Dependence - urine; Hospitalization; Hospitals; Humans; Male; Medical sciences; Mental health; Middle Aged; Opiate abuse; Opiates; Organization of mental health. Health systems; Patient Dropouts; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Regression Analysis; Retrospective Studies; Risk Factors; Social psychiatry. Ethnopsychiatry; Substance Withdrawal Syndrome - drug therapy; Substance Withdrawal Syndrome - urine; Substance-Related Disorders - drug therapy; Substance-Related Disorders - urine; Treatment; USA; Clonidine; Opiate abuse; Against medical advice; Diazepam; Detoxification; Short term; Human; Drug addiction; Hospital discharge; Treatment; Dependence; Prediction; Treatment compliance; Opiates; Hospitalization; Clinical counseling
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/S0376-8716(99)00027-7

The primary goal of this study was to identify factors associated with patients leaving a 3-day hospital detoxification unit against medical advice (AMA). Medical records of 302 patients who were admitted for alcohol or other drug withdrawal were reviewed. Variables examined were: demographics, reported history of drug use, urine toxicology at admission, medication received during the detoxification, and admission day. Data were analyzed using a case-control design. Logistic regression was used to identify independent predictors. We found that being younger, having a shorter history of cocaine abuse, being admitted on a Friday and being an opiate dependent patient treated with clonidine only during the detoxification, were significantly associated with leaving AMA. These findings may provide information that can help clinicians identify those patients who are most at risk for leaving AMA. This will in turn allow them the opportunity to initiate preventive measures to decrease unnecessary attrition and improve utilisation of treatment resources.