Pattern of attendance and predictors of default among Nigerian outpatients with schizophrenia.
OBJECTIVE
To assess the pattern of and factors associated with outpatient clinic attendance among patients diagnosed with schizophrenia at a Nigerian psychiatric hospital.


METHODS
This was a cross-sectional descriptive study of 313 consecutive outpatients with diagnosis of schizophrenia confirmed with the Structured Clinical Interview for Diagnosis (SCID). Data was collected on sociodemographics, clinic attendance, perceived social support, perceived satisfaction with hospital care and illness severity (assessed using the Brief Psychiatric Rating Scale, BPRS). Logistic regression analysis was used to identify factors associated with outpatient clinic default.


RESULTS
Overall, 20.4% respondents were defaulters, with a median duration of clinic non-attendance of 8 weeks. Outpatient clinic defaulters had significantly higher BPRS scores and had missed more outpatient clinic appointments compared with non-defaulters. A significantly higher proportion of defaulters resided more than 20 km away from the hospital and reported "not satisfied" with their outpatient care. Being financially constrained was the commonest reason given by defaulters for missing their clinic appointments. The significant predictors of outpatient clinic default included residing more than 20 km from the hospital, missing previous appointments and dissatisfaction with outpatient care.


CONCLUSIONS
Outpatient clinic non-attendance is common among patients with schizophrenia, and is significantly associated with demographic, clinical and service related factors. Interventions targeted at addressing the risk factors for defaulting peculiar to developing country settings similar to the location of this study, could significantly improve treatment outcome.
Department of Psychiatry, Ladoke Akintola University Teaching Hospital, Ogbomoso, Oyo State, Nigeria.
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Adelufosi
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Ogunwale
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Adeponle
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Abayomi
D000328:Adult; D000553:Ambulatory Care / Q000523:psychology / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility / Q000592:standards; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008605:Mental Health Services; D008875:Middle Aged; D009549:Nigeria; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data; D010045:Outpatients / Q000523:psychology*; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data; D057240:Patient Preference / Q000523:psychology / Q000706:statistics & numerical data; D012559:Schizophrenia / Q000628:therapy*; D012565:Schizophrenic Psychology