[Systematic decision-making can help in ending long-term treatments].

Abstract

Background: The professional literature places considerable emphasis on the content of treatments, yet relatively little attention is given to their conclusion. When should a treatment be terminated, and how? In practice, there are few guidelines for ending treatment, particularly in the case of long-term interventions that may no longer significantly contribute to further improvement. A careful conclusion is, however, an essential component of any treatment. Due to a lack of attention to the termination process, treatments may continue longer than necessary, resulting in higher costs. Consequently, patients on waiting lists experience delays in accessing care.

Aim: To describe and evaluate a method by which long-term treatments can be systematically assessed and, when appropriate, brought to a conclusion.

Method: A description of the multidisciplinary ‘outtake afternoon’ at the TOPGGz depression outpatient clinic of GGZ inGeest, the use of an outtake form, and the results of this approach.

Results: A total of 65 patients were reviewed, with an average treatment duration of 79 weeks. In just over half of the cases (54%), the evaluation prompted the initiation of a discharge trajectory. Of the patients for whom such a trajectory was initiated, 50% were formally discharged from the outpatient clinic within three months. In addition, relevant problems and dilemmas could be clearly articulated, and clinicians reported feeling supported in their decision-making and actions through this approach.

Conclusion: Periodic, systematic evaluation of long-term treatments can facilitate their timely and appropriate conclusion.