Tijdschrift voor psychiatrie, Volume 67, Issue 7, 1 1 2025, Pages 403-406 [Systematic decision-making can help in ending long-term treatments]. Poolen F, Verhoeven J, van Schaik DJF, Reinders MJ, van der Wart MT, Vinkers CH
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.
