Why Do Patients in Tuberculosis Hospitals Leave Against Medical Advice?

Drolet, Godias J.; Porter, Donald E.

doi:10.1097/00000446-194908000-00040

Cited by 9 publications

(5 citation statements)

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“…There is considerable evidence that despite his greater exposure to treatment, a patient who has previously dropped out of treatment is much more likely to do so on a present admission than a new admission or than one who is seeking treatment for the first time (Baekeland et al, 1973;Drolet & Porter, 1949;G. G. Meyer et al, 1967;Rickels, 1966;Zax, Marsey, & Biggs, 1961).…”

Section: New Versus Readmitted Patientsmentioning

confidence: 99%

“…Tuberculous inpatients who leave against medical advice or elope have similar characteristics. Compared with those who remain in the hospital, they have been reported to be sicker (Drolet & Porter, 1949), to be more likely previously to have eloped or signed out against advice (Bowen, Soskin, & Chotlos, 1970;Drolet & Porter, 1949;R. G. Newman & Kagen, 1973;Shelton & Sparer, 19S6), to sign out early in their hospitalization (Drolet & Porter, 1949;Shelton & Sparer, 1956), and to have service-connected tuberculosis (J.…”

Section: Elopement From the Hospital And Termination Of Treatment Aga...mentioning

confidence: 99%

“…Symptom levels and symptom relief appear to be a double-edged sword in dropping out of treatment, implicated in 22 out of 35 studies (62.8%) (Baekeland et al, 1973;Bailey et al, 1959;Brown & Kosterlitz, 1964;Drolet & Porter, 1949;Fisch et al, 1973;Frank et al, 1957;Gallagher & Kanter, 1961;Greenwald & Bartemeier, 1963;Heilbrun, 1971;Hiler, 1959;Katz & Solomon, 1958;Levine et al, 1972;Nash et al, 1957;J. Newman & Sparer, 1956;Perkins & Bloch, 1971;Raynes & Patch, 1971;Rickels & Anderson, 1969;Ross & Lacey, 1961;Taulbee, 1958;Wilkinson et al, 1971; and found irrelevant in 13 others out of 35 (37.2%) (Affleck & Garfield, 1961;Babst etal., 1971;Calden et al, 1956;Dodd, 1971;Downing et al, 1970;Errera et al, 1967;Levitt, 1958;Lorr et al, 1958;E.…”

Section: Symptom Levels and Symptom Reliefmentioning

confidence: 99%

“…Poor motivation or variables related to it have often been implicated in defection from' treatment. In fact, 34 out of 41 studies (82.9%) surveyed thought it important (Altman, Baekeland et al, 1973;Caine et al, 1973;Drolet & Porter, 1949;Frank et al, 1957;Goldfried, 1969;Heilbrun, 1973;Katkov, 1958;Lake & Levinger, 1960;Lewis et al, 1955;Mayer, 1972;Mendelsohn & Geller, 1967;E. Meyer et al, 1967;G.…”

Section: Motivationmentioning

confidence: 99%

“…During outpatient detoxification patient losses range from 26% to 68.6% (Cusky, Chambers, & Wieland, 1971;Raynes et al, 1973;Werner, Newman, Hooper, & Craig, 1973;, in inpatient detoxification from 23% to 39% (Raynes et al, 1973;White, 1972), and in a drug-free program 82% of the patients failed to continue treatment for more than 4 months (Kaufman, 1972). Similarly, 37%-60.2% of tuberculous inpatients have been reported to sign out against advice (Drolet & Porter, 1949;J. Newman & Sparer, 1956;Wilmer, 1956).…”

mentioning

confidence: 99%

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Dropping out of treatment: A critical review.

Baekeland

Lundwall²

1975

Psychological Bulletin

1,016

554

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After a discussion of methodological issues of the past 20 years, literature on dropping out of treatment was critically reviewed in six areas: hospital treatment of general psychiatric and tubercular patients, outpatient treatment of internal medical conditions, alcoholism, heroin addiction, general psychiatric outpatient psychotherapy, and double-blind drug studies. Fifteen factors were found to predict dropping out in 100%, 83%-88%, and 60%-75% of the relevant studies: (a) social isolation and/or unaffiliation, therapist attitudes and behavior, discrepancies between patient and therapist treatment expectations; (b) passive-aggressive behavior, family attitudes and behavior, motivation, behavioral and/or perceptual dependence, psychological mindedness and/ or -denial, symptom levels and symptom relief, socioeconomic status, sociopathic features, alcoholism and/or drug dependence; (c) age, sex, and social stability.One of the most vexing problems facing the physician, whether he is a surgeon, internist, or psychiatrist, is that far too many of those entrusted to his care, both inpatients and outpatients, drop out of treatment before they have completed it to his satisfaction. Although the question of the dropout has most often engaged the attention of psychiatrists, it also crops up from time to time in papers by internists, for whom there is no reason to believe that it is any less serious a problem. Where studied, the dropout problem has usually been in the context of treating chronic conditions that require prolonged treatment. The extent of this problem can be inferred ^rom the fact that in general psychiatric clinics, 20%-57% of the patients fail to return after the first visit (Blenkner,

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Section: New Versus Readmitted Patientsmentioning

confidence: 99%

Section: Elopement From the Hospital And Termination Of Treatment Aga...mentioning

confidence: 99%

Section: Symptom Levels and Symptom Reliefmentioning

confidence: 99%

Section: Motivationmentioning

confidence: 99%

mentioning

confidence: 99%

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Dropping out of treatment: A critical review.

Baekeland

Lundwall²

1975

Psychological Bulletin

1,016

554

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Drug administration research — The contribution of pharmacoepidemiology to pharmaceutical monitoring

Bruppacher

1996

Pharmaceutica Acta Helvetiae

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Patient compliance-an overview

Morris¹,

Schulz²

1992

Journal of Clinical Pharmacy and Therapeutics

273

162

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SUMMARYThis article reviews the major topic areas of compliance research. Much of the research in the area has focused on measurement, extent, and determinants of non-compliance. Research on the effectiveness of educational and behavioural strategies to improve compliance suggests the need to combine them. While some authors have attempted to model compliance or medication-taking behaviours, these models cannot be applied widely.After decades of compliance research, very little consistent information is available, except that people do not take their medications as prescribed. The methodological rigour of compliance studies may partially contribute to this situation. Methodological flaws have included design features and study execution. In addition, researchers have proceeded with studies without regard to a theoretical framework.Many have argued that much of the existing compliance literature also lacks conceptual rigour. Although we know that people do not take their medications consistently, we do not know specifically why they have done so. One reason for this lack of understanding is that compliance research has been dominated by the perspective of the health professional. To better understand medicationtaking behaviour, researchers need to examine the patient's perspective. Consequently, future research needs to investigate a patient's decisionmaking process and the reasons for those decisions.

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Why Do Patients in Tuberculosis Hospitals Leave Against Medical Advice?

Cited by 9 publications

References 0 publications

Dropping out of treatment: A critical review.

Dropping out of treatment: A critical review.

Drug administration research — The contribution of pharmacoepidemiology to pharmaceutical monitoring

Patient compliance-an overview

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