[Refusal of treatment]

Abstract

The 25-50% of the outpatients who ask for medical assistance give up the treatment before the end for several reasons. The immediate consequences are the waste of economic and assistance resources, professional insatisfaction, phenomena like revolving door and bad results in prescribed treatments. These patients usually come back in the medium or long term. The authors considered to review the material published between 1992-1998 on the variables associated to the phenomena of noncompliance and dropout, as well as the strategies proposed by the different authors to face this problem.

Method: A search was performed for original and review articles on the issue in the Medline database between 1992-1997. The key words used were: dropout, appointments, schedules, non attendance, premature termination, non compliance, medication compliance and their links with the key words: psychiatry, psychotherapy and mental disorder. The bibliographic references were classified according to the type of article, author, country of origin, journal and year. In relation with the contents, one classification has been carried out according to approach strategies, and another according to variables associated to dropout and non compliance.

Results: 144 bibliographic references were identified after the search on the Medline database. The selection for revision included 24 original articles, 5 review articles and a letter to the editor as a comment to a previous article. The total number of different journals was 27, and the authors were from 6 different nationalities.