Characterizing of dropouts in the mental health of refugees and asylum seekers (MEHIRA) study examining the effects of a stepped and collaborative care model – a multicentered rater-blinded randomized controlled trial

  • Background Dropout from healthcare interventions can negatively affect patients and healthcare providers through impaired trust in the healthcare system and ineffective use of resources. Research on this topic is still largely missing on refugees and asylum seekers. The current study aimed to characterize predictors for dropout in the Mental Health in Refugees and Asylum Seekers (MEHIRA) study, one of the largest multicentered controlled trials investigating the effectiveness and cost-effectiveness of a nationwide stepped and collaborative care model. Methods Predictors were multiply imputed and selected for descriptive modelling using backward elimination. The final variable set was entered into logistic regression. Results The overall dropout rate was 41,7%. Dropout was higher in participants in group therapy (p = 0.001; OR = 10.7), with larger satisfaction with social relationships (p = 0.017; OR = 1.87), with difficulties in maintaining personal relationships (p = 0.005;Background Dropout from healthcare interventions can negatively affect patients and healthcare providers through impaired trust in the healthcare system and ineffective use of resources. Research on this topic is still largely missing on refugees and asylum seekers. The current study aimed to characterize predictors for dropout in the Mental Health in Refugees and Asylum Seekers (MEHIRA) study, one of the largest multicentered controlled trials investigating the effectiveness and cost-effectiveness of a nationwide stepped and collaborative care model. Methods Predictors were multiply imputed and selected for descriptive modelling using backward elimination. The final variable set was entered into logistic regression. Results The overall dropout rate was 41,7%. Dropout was higher in participants in group therapy (p = 0.001; OR = 10.7), with larger satisfaction with social relationships (p = 0.017; OR = 1.87), with difficulties in maintaining personal relationships (p = 0.005; OR = 4.27), and with higher depressive symptoms (p = 0.029; OR = 1.05). Participants living in refugee accommodation (p = 0.040; OR = 0.45), with a change in social status (p = 0.008; OR = 0.67) and with conduct (p = 0.020; OR = 0.24) and emotional problems (p = 0.013; OR = 0.31) were significantly less likely to drop out of treatment. Conclusion Overall, the outcomes of this study suggest that predictors assessing social relationships, social status, and living conditions should be considered as topics of psychological treatment to increase adherence and as predictors for future research studies (including treatment type).show moreshow less

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Author:Solveig Kemna, Max Bringmann, Carine Karnouk, Andreas Hoell, Mira Tschorn, Inge Kamp-Becker, Frank Padberg, Aline Übleis, Alkomiet HasanORCiDGND, Peter Falkai, Hans-Joachim Salize, Andreas Meyer-Lindenberg, Tobias Banaschewski, Frank Schneider, Ute Habel, Paul Plener, Eric Hahn, Maren Wiechers, Michael Strupf, Andrea Jobst, Sabina Millenet, Edgar Hoehne, Thorsten Sukale, Martin Schuster, Raphael Dinauer, Nassim Mehran, Franziska Kaiser, Klaus Lieb, Andreas Heinz, Michael Rapp, Malek Bajbouj, Kerem Böge
Frontdoor URLhttps://opus.bibliothek.uni-augsburg.de/opus4/118067
ISSN:0033-2917OPAC
ISSN:1469-8978OPAC
Parent Title (English):Psychological Medicine
Publisher:Cambridge University Press (CUP)
Place of publication:Cambridge
Type:Article
Language:English
Year of first Publication:2025
Publishing Institution:Universität Augsburg
Release Date:2025/01/16
DOI:https://doi.org/10.1017/s0033291724003179
Institutes:Medizinische Fakultät
Medizinische Fakultät / Lehrstuhl für Psychiatrie und Psychotherapie
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Latest Publications (not yet published in print):Aktuelle Publikationen (noch nicht gedruckt erschienen)
Licence (German):CC-BY 4.0: Creative Commons: Namensnennung (mit Print on Demand)