Predictors of and reasons for early discharge from inpatient withdrawal management settings: A scoping review.
adult
inpatients
patient discharge
substance-related disorders
treatment refusal
Journal
Drug and alcohol review
ISSN: 1465-3362
Titre abrégé: Drug Alcohol Rev
Pays: Australia
ID NLM: 9015440
Informations de publication
Date de publication:
Jan 2022
Jan 2022
Historique:
revised:
27
03
2021
received:
06
12
2020
accepted:
25
04
2021
pubmed:
28
5
2021
medline:
1
4
2022
entrez:
27
5
2021
Statut:
ppublish
Résumé
Early discharges, also known as 'against medical advice' discharges, frequently occur in inpatient withdrawal management settings and can result in negative outcomes for patients. The purpose of this scoping review is to identify what is known about predictors of and reasons for the early discharge among adults accessing inpatient withdrawal management settings. MEDLINE, CINAHL, PsycINFO, ASSIA and EMBASE were searched, resulting in 2587 articles for screening. Title and abstract screening and full-text review were completed by two independent reviewers. Results were synthesised in quantitative and qualitative formats. Sixty-two studies were included in this scoping review. All studies focused on predictors of early discharge, except one which only described reasons for the early discharge. Forty-eight percent of studies involved retrospective review of health records data. The most frequently examined variables were demographics. Variables related to the treatment setting, such as referral source and treatment received, were examined less frequently but were more consistently associated with early discharge compared to demographics. Only six studies described patient reasons for the early discharge, which were retrieved via clinical documentation. The most common reasons for early discharge were dissatisfaction with treatment and family issues. Most demographic variables do not consistently predict early discharge, and reasons for early discharge are not well understood. Future studies should focus on the predictive value of non-patient-level variables, or conduct analyses to account for predictors of early discharge among different subgroups of people (e.g. by gender or ethnicity). Qualitative research exploring patient perspectives is needed.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
62-77Informations de copyright
© 2021 Australasian Professional Society on Alcohol and other Drugs.
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