Effects of a brief pre-admission telephone reminder on no-show and dropout rates in substance use disorder treatment: a quasi-experimental study

Lisbeth Jensen Gallefoss, Karin Berle Gabrielsen, Siri Håvås Haugland, Thomas Clausen, John-Kåre Vederhus, Lisbeth Jensen Gallefoss, Karin Berle Gabrielsen, Siri Håvås Haugland, Thomas Clausen, John-Kåre Vederhus

Abstract

Background: Appointment no-show and early dropout from treatment represent major challenges in outpatient substance use disorder treatment, adversely affecting clinical outcomes and health care productivity. In this quasi-experimental study, we examined how a brief reminder intervention for new patients before their first appointment affected treatment participation and retention. No-shows (not attending any sessions) and dropouts (discontinuation of initiated treatment because of three consecutively missed appointments) were compared between a period with pre-admission telephone calls (intervention) and a period without such reminders (non-intervention).

Methods: Participants were all eligible patients (N = 262) admitted to a Norwegian specialist clinic for substance use disorder treatment. We used the Chi-square test for the no-show analysis. Of the eligible patients, 147 were included in a subsequent dropout analysis. We used the number of visits up to 10 appointments as a measure for time to event. Group differences were analyzed using a Kaplan-Meier plot and the log-rank test. To control for relevant sociodemographic variables, as well as substance use and mental distress severity, we used Cox regression.

Results: No-show rates did not differ between the two periods (12% for non-intervention vs. 14% for intervention; χ2 = 0.20, p = 0.653). Of those consenting to participate in the dropout analysis (n = 147), 28 (19%) discontinued treatment within the time frame of 10 appointments, with no differences between the two periods (log-rank test = 0.328, p = 0.567). Controlling for baseline characteristics did not alter this finding. In fact, of the registered covariates at baseline, only higher education level was associated with attrition, linked to a reduced risk for dropout (hazard ratio = 0.85, 95% CI = 0.74-0.98, p = 0.025).

Conclusion: These findings do not provide support for the systematic use of a brief pre-admission telephone reminder in the current treatment setting.

Trial registration: The study was retrospectively registered 13 Jan 2021 at ClinicalTrials.gov, NCT04707599.

Keywords: Norway; Outpatient treatment; Reminder systems; Substance use disorders; Telephone reminder.

Conflict of interest statement

The authors have no conflicts of interest to declare that are relevant to the content of this article.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Flow chart of study participants (N = 262)
Fig. 2
Fig. 2
Kaplan–Meier plot showing dropout rate for the non-intervention period (blue line, without telephone reminder; n = 66) and intervention period (red line, with telephone reminder; n = 81). Log-rank test = 0.328 (p = 0.567)

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