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theses

Purpose of Project: Alcohol and substance use have been a contributing factor to economic and health issues affecting different parts of the world. Alcohol and substance use affect both the individual using the substances as well those other people around the individual. While treatment options have been available for alcohol and illicit substance users, an issue that continues to affect patient outcomes is treatment retention rates in outpatient settings. Literature has shown a large number of clients who begin treatment will stop treatment before its completion. Evaluating barriers and finding methods to improve outpatient rates can help to improve overall patient outcomes. The clinical question being asked is What are the changes to outpatient treatment (I) that can help increase retention rates (O) for clients who identify as using alcohol and/or illicit substances (P)? This project sought to identify clients that potentially use alcohol and/or illicit substance in order to find out what contributes to non-compliance in outpatient treatment.

Methodology: This was done through a retrospective chart review of 227 charts and 25 structured interviews of clients in the outpatient psychiatric program.

Results: The review concluded that of the 227 charts, only 39% completed treatment. Of the remaining cases, 46% were closed out due to an unknown reason, and less than 1% had an identifiable barrier to attending treatment. The barriers were related to scheduling conflicts and transportation issues. Upon completion of the chart review, a structured interview was completed on 20 individuals that identified barriers to treatment. The results of the interviews noted 10 (50%) individuals with issues regarding transportation, 4 (20%) individuals having financial issues, 5 (25%) individuals with issues with the treatment team, 1 (5%) individual with schedule related issues, 2 (10%) individuals reporting medication related issues, 1 (5%) individual reporting it made the person feel like it was a sign of weakness, 1 (5%) individual reporting a depressed mood and low self-esteem, and 1 (5%) individual not having any interest in stopping using his or her drug of choice. The total results were greater than 100% because certain individuals noted multiple barriers to treatment. Based on the results of the chart review and structured interview, possible recommendations were identified that can help to decrease the barriers to attending treatment.

Implications for Practice: Recommendations included adjustments in appointment availability, transportation options, such as van service or taxi service, staff education, and treatment of underlying depressed mood were included. Moving forward, it will be important to use current knowledge to focus on implementing these or other recommendation in order to further assist clients in achieving a better patient outcome.

ETD_10814

DNP

Includes bibliographical references

doi:10.7282/t3-aj97-kq09

ETD doctoral

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