Patients who terminate OMT--how do they fare?

BACKGROUND OMT tends to involve treatment over an extended period of time. Some OMT patients terminate the treatment. There is a need for more knowledge about how these persons do following treatment. MATERIAL AND METHOD We undertook a retrospective review of patient records at Sørlandet Hospital in Kristiansand for patients who had undergone OMT in the period 1998-2009. Data from 103 discharged patients were included in the study, registered on two occasions--31 December 2009 and 30 June 2011. RESULTS Of the 469 patients who started their OMT during the period of study, altogether 103 patients (22%) terminated the treatment. One-half of the 103 patients who terminated their treatment did so because they no longer wanted OMT or failed to report to the hospital. The others terminated the treatment because they wanted medication from their GP other than OMT (n = 11), because they considered themselves to be no longer addicted and in need of treatment (n = 19) or because they maintained a considerable substance use (n = 21). Seven patients wanted a planned tapering-off of OMT drugs. The status for these 103 discharged patients as of 31 December 2009 (median 1,034 days after discharge) was: uncontrolled substance use: 30%; dead: 17%; other medication from GP: 14%; psychiatric treatment: 12%; imprisoned: 8%; OMT in another county: 2%; drug-free without maintenance treatment: 11%; unknown: 6%. Eighteen months later, altogether 36 of them had changed their status. The group with uncontrolled substance use (n = 31) had undergone the greatest change--altogether 14 were back in OMT, ten continued their substance use and four had died. INTERPRETATION The OMT patients who terminated the treatment had a high rate of mortality. Approximately 10 % of those discharged lived stable drug-free lives without OMT medication during the period of observation.