Individual and Program Predictors of Attrition from VA Substance Use Treatment

Abstract

The study investigated patient- and program-level variables associated with attrition from intensive outpatient (IOP) substance use treatment in a national VA sample. National databases were used to identify a recent cohort of veterans receiving intensive IOP substance use treatment. Attrition was defined as receiving less than five visits of IOP treatment. Patient-level variables examined included age, gender, race, and psychiatric and medical comorbidities. Program-level variables examined included the number of hours of treatment offered, the percentage of patients living on-campus, and extent of staff cuts in the past year. Twenty-seven percent of veterans left treatment early. Being older, female, and having a psychotic disorder was associated with attrition. Program-level factors associated with attrition were the number of hours the program offered treatment, in that more treatment offered was associated with higher attrition. Focus on individual and program level factors associated with attrition is crucial to retaining individuals in treatment.

Differences in Outcomes, Completion Rates, and Perceptions of Treatment Between White, Black, and Hispanic LGBT Clients in Substance Abuse Programs

“…However, other studies found no significant differences in retention rates based on race, particularly after controlling for psychosocial factors (Booth, Corsi, & Mikulich-Gilbertson, 2004;Brewer, Catalano, Haggerty, Gainey, & Fleming, 1998;Curran, Stecker, Xiaotong, & Booth, 2009;Howard, LaVeist, & McCaughrin, 1996;Justus, Burling, & Weingardt, 2006;Knight, Logan, & Simpson, 2001;Magura, Nwakeze, & Demsky, 1998;Sayre et al, 2002). In this current study of the LGBT population, there were no differences in program completion rates based on race.…”

Recent Achievements in Alcohol and Drug Abuse Health Services Research

“…Two papers in this special issue study utilization of services in vastly differing populations: veterans in VA intensive outpatient treatment 6 and adolescents in community-based substance abuse outpatient clinics. 5 Both papers address significant clinical issues for their respective populations that may have adverse effects upon treatment outcomes: early attrition from VA services and co-occurring mental health problems in adolescents.…”

“…If programs are to enhance their quality of care, they must organize their service delivery systems appropriately. The paper of Curran et al 6 examines both program-level and individual factors associated with early attrition, thus providing insight into organizational factors that may affect patient behavior.…”

“…This special issue reflects this diversity and contains papers where research was conducted in multiple settings including individuals in the welfare system, 1 a method for assessing the cultural competency of substance abuse treatment programs, 2 juvenile drug courts, 3 adolescent substance abuse treatment, 4,5 and adult substance abuse treatment in the Department of Veterans Affairs' healthcare system. 6 The populations covered are also wide-ranging and include veterans, adolescents with comorbid substance abuse and mental health problems, juvenile drug court participants, women receiving welfare [either General Assistance or Temporary Aid to Needy Families (TANF)], and MexicanAmericans. This examination of a variety of at-risk populations bears witness to ADAHSR researchers' commitment to vulnerable populations, to alternatives to formal substance abuse treatment, and to utilizing research to inform policy.…”

Profile of Patients with Dual Diagnosis: Experience from an Integrated Dual Diagnosis Clinic in North India

“…Those who remained in the treatment net, significant proportion (45.7%) of patients were improved. High dropout rate has also been observed in the studies from the US and the rate of dropout after first contact is as high as 42% [13]. Half of the subjects were failed to be engaged in the treatment because of their short follow up duration [13].…”