Determinants of risk of relapse among patients treated for alcohol addiction at selected rehabilitation centres in Meru county, Kenya

Abstract

Alcohol addiction constitutes a severe public health concern globally and locally. Though there are many treatments available, the rate of relapse in alcohol addiction worldwide is often much higher than 50%. In Kenya, many adults have alcohol use disorder and the rate of relapse is similarly high ranging between 20 and 80%. This study aimed at examining the prevalence of risk of relapse, psychosocial factors related to the risk of relapse, and the environmental factors related to the risk of relapse among patients treated for alcohol addiction at selected rehabilitation centres in Meru County. The study employed analytical cross-sectional design and mixedmethods of collection of data. Prior to the data collection, a pretest was carried out on 13 patients in comparable facility to test the validity of the semi questionnaire and key informants. A reliability coefficient of 0.804 was obtained. One hundred and thirty (130) primary respondents participated in the study and six (6) key informants. Census method was used to include participants in the study. The research instruments used included a semi-structured questionnaire and standardized tool called Advanced Warning of Relapse Questionnaire (AWARE), which were used to collect quantitative data. Key informant schedule was used to collect qualitative data. Quantitative data was analysed using a computer software, IBM SPSS Statistics 29, while qualitative data was analysed by use of thematic network analysis. Descriptive statistic, chisquare test, and logistic regression analysis was carried out. Results revealed that from the 130 patients, 98(75.4%) patients were at high risk of relapse while 32(24.6%) patients were at low risk of relapse. Majority of them 79(60.8%) were aged between 20 to 34 years. Males, 113 (86.9%) were majority. The urge to drink alcohol (p=0.004), thinking about relapsing (p=0.040), experiencing feeling of low mood, hopelessness and feeling depressed (p=0.012) were identified as the psychosocial determinants while living with alcohol users (p= 0.015) and ease access of alcohol (p=0.032) were the environmental factors influencing the risk of relapse among patients treated for alcohol addiction. The findings underscore the role played by psychosocial and environmental factors in the risk of relapse among patients treated for alcohol addiction. The insights from the study can be used by psychologists and counsellors to improve in their clinical approaches thus promoting long term recovery. There is a need of collaborative working between the clinicians, the society, recovering patients and policy makers in order to ensure long term recovery of those recovering from alcohol addiction. Intervention-based studies of the effectiveness of certain programs that limit environmental access to alcohol can be carried out to obtain evidence-based methods of dealing with relapse.