Mobile phone intervention to reduce dropout from treatment at an outpatient mental health service for older people in Nigeria

Background: Half of older Africans drop out of treatment after a single contact with biomedical mental health services. Objective: This study examined the effect of introducing a mobile phone reminder intervention delivered by volunteering health staff to reduce dropout from an outpatient mental health service for older people in Nigeria. Methods: 405 patients were studied using a quasi-experimental design: 169 who attended clinic pre-intervention (2016-2017) and 236 who attended during intervention (2018-2019). We estimated annual dropout rates, reasons for dropout and predictors of drop-out. Results: We found a trend for decreasing dropout rates during intervention (p<0.001). The most common reasons for dropout were distance to the clinic (19.5%) and unavailability of a caregiver (47.6%). Current single status (O.R =2.02, 95% C. I=1.02-3.99) and treatment without adjunctive pharmacotherapy (O. R=2.14, 95% CI; 1.07-4.26) predicted dropout. Conclusion: Mobile phone call reminders improved treatment engagement in this population. Findings are important for policy to access to mental healthcare in Africa.