Assessment of a discharge planning program on treatment adherence for inpatients with psychiatric disorders

Treatment adherence is a critical challenge in managing both physical and mental health conditions. For psychiatric patients, enhancing adherence significantly lowers readmission rates, thereby reducing healthcare costs and improving satisfaction levels among both patients and caregivers. This study aimed to evaluate the impact of a specifically designed discharge program on improving treatment adherence in severely ill psychiatric inpatients at an Iranian teaching psychiatric hospital during 2022. This pre-post case-control study, conducted as a pre- and post-intervention design at the Psychiatric Teaching Hospital in Sanandaj, Iran, involved designing (based on literature review, hospital assessment, and an evidence-based model) and implementing a discharge program. It included adults (≥ 18 years) with schizophrenia, schizoaffective disorder, or bipolar disorder, divided into a control group ( n = 133) and an intervention group ( n = 136). The control group was sampled in the first quarter of 2022, and the intervention group was sampled in the third quarter of the same year. Participants were followed for six months post-discharge, with outcomes measured including treatment adherence (using the MMAQ-8 via phone at one month), attendance at the first scheduled follow-up visit (dichotomous, via phone at one month), and the number of readmissions (determined via hospital records within six months). Data analysis was performed using Stata version 16, employing independent t-tests, chi-square tests, and Fisher’s exact tests. Following the discharge plan implementation, the intervention group demonstrated significantly higher treatment adherence, a considerably higher rate of attendance at the first scheduled post-discharge visit, and a significantly lower readmission rate within six months compared to the control group ( p < 0.001 for all outcomes). Overall, the discharge program—rooted in patient and family education and implemented through collaboration between the treatment team and families—proved highly effective, significantly improving treatment adherence, boosting attendance at the first post-discharge visit, and reducing patient readmissions. IRCT20180114038350N4. Registration date: 2026-08-20.