Perception of Spanish professionals on therapeutic adherence of dual diagnosis patients.

OBJECTIVE The aim of this study is to determine the health professionals perspective about the therapeutic adherence among dual diagnosis patients. It also analyzed the most frequently used pharmacological and nonpharmacological treatments. The aim is to learn the professional;s perception regarding the reasons for nonadherence and to identify the type of strategies that may improve adherence. METHODOLOGY We performed an on-line survey that was answered by 169 health professionals (79.8%, doctors or psychologists) who were working in centers where the dual diagnosis patients could be treated (Mental Health Centers, Drug Outpatients Clinics, Inpatient Unit, private practice). RESULTS A majority of the mental health professionals perceive the existence of non-compliance of dual diagnosis patients and they consider that 29.8% have no compliance and 39.15% have partial compliance. In addition, 96.2% believe that treatment nonadherence can be related with poor evolution in a severe or very severe degree. The reasons for the nonadherence to treatment are the poor disease awareness, side effects, low efficacy and complicated posologies. No differences were found regarding the difficulties and reasons for non-compliance between professionals or centers. It is proposed that using drugs with low side effects drugs and easy-to-manage can improve compliance. It is also proposed to use motivational techniques, psychoeducation and psychological treatment. CONCLUSIONS The perception exists that a high proportion of dual patients have poor treatment adherence, which affects the therapeutical process. Efforts should be done to improve the pharmacological and nonpharmacological treatment.

[1]  J. M. Vázquez,et al.  Percepción de los profesionales Españoles sobre la Adherencia Terapéutica en Patología Dual , 2013 .

[2]  C. Roncero,et al.  Risk factors for cocaine-induced psychosis in cocaine-dependent patients , 2011, European Psychiatry.

[3]  P. Vega,et al.  Cocaine abuse or dependency and other pyschiatric disorders. Madrid study on dual pathology. , 2013, Revista de psiquiatria y salud mental.

[4]  G. Perugi,et al.  Correlations Between Awareness of Illness (Insight) and History of Addiction in Heroin-Addicted Patients , 2012, Front. Psychiatry.

[5]  José J Rodríguez-Solano,et al.  Psychiatric disorders associated with alcoholism: 2 year follow-up of treatment. , 2012, Actas espanolas de psiquiatria.

[6]  C. Roncero,et al.  Treatment adherence to treatment in substance users referred from Psychiatric Emergency service to outpatient treatment. , 2012, Actas espanolas de psiquiatria.

[7]  C. Roncero,et al.  [Evaluation of sleep disorders in drug dependent inpatients]. , 2012, Medicina clinica.

[8]  A. Douaihy,et al.  Treatment of substance abusing patients with comorbid psychiatric disorders. , 2012, Addictive behaviors.

[9]  C. Roncero,et al.  Protocols of Dual Diagnosis Intervention in Schizophrenia , 2011 .

[10]  M. Escamilla,et al.  Substance use disorder and schizophrenia: prevalence and sociodemographic characteristics in the Latin American population. , 2011, Actas espanolas de psiquiatria.

[11]  C. Roncero,et al.  Therapeutic management and comorbidities in opiate-dependent patients undergoing a replacement therapy programme in Spain: the PROTEUS study , 2011 .

[12]  D. Lacasta-Tintorer,et al.  [Do depressed patients comply with treatments prescribed?: a cross-sectional study of adherence to the antidepressant treatment]. , 2011, Actas espanolas de psiquiatria.

[13]  F. Arias Horcajadas,et al.  [Pilot study on the prevalence of dual pathology in community mental health and substance misuse services in Madrid]. , 2011, Adicciones.

[14]  C. Roncero,et al.  [Epidemiological and diagnostic axis I gender differences in dual diagnosis patients]. , 2011, Adicciones.

[15]  P. Weiden,et al.  Assessment of Adherence Problems in Patients with Serious and Persistent Mental Illness: Recommendations from the Expert Consensus Guidelines , 2010, Journal of psychiatric practice.

[16]  J. Lindenmayer,et al.  Safety and tolerability of deltoid and gluteal injections of paliperidone palmitate in schizophrenia , 2009, Progress in Neuro-Psychopharmacology and Biological Psychiatry.

[17]  E. Vieta,et al.  [Efficacy and safety of long-acting injectable risperidone in maintenance phase of bipolar and schizoaffective disorder]. , 2009, Actas espanolas de psiquiatria.

[18]  J. López Castro,et al.  [Benzodiazepine use in a sample of patients on a treatment program with opiate derivatives (PTDO)]. , 2009, Adicciones.

[19]  M. Roca,et al.  [Use of antidepressant treatment. Patients' perception]. , 2009, Actas espanolas de psiquiatria.

[20]  J. Martínez-Raga,et al.  Bipolar disorder associated to substance use disorders (dual diagnosis). Systematic review of the scientific evidence and expert consensus. , 2008, Actas espanolas de psiquiatria.

[21]  D. Karlovic,et al.  Assessment of nurse attitudes on psychiatric patient compliance with pharmacotherapy. , 2008, Acta clinica Croatica.

[22]  R. Baldessarini,et al.  Factors associated with treatment nonadherence among US bipolar disorder patients , 2008, Human psychopharmacology.

[23]  J. Hoenicka,et al.  [Dual diagnosis in psychiatric inpatients: prevalence and general characteristics]. , 2008, Investigacion clinica.

[24]  C. Grella,et al.  Role of social support and self-efficacy in treatment outcomes among clients with co-occurring disorders. , 2007, Drug and alcohol dependence.

[25]  R. Drake,et al.  Schizophrenia and co-occurring substance use disorder. , 2007, The American journal of psychiatry.

[26]  A. Gual.  Dual diagnosis in Spain. , 2007, Drug and alcohol review.

[27]  R. Drake,et al.  Enhancing validity in co-occurring disorders treatment research. , 2005, Schizophrenia bulletin.

[28]  Alan I Green,et al.  Improving the Care of Individuals with Schizophrenia and Substance Use Disorders: Consensus Recommendations , 2005, Journal of psychiatric practice.

[29]  D. Kavanagh,et al.  Integrated versus non-integrated management and care for clients with co-occurring mental health and substance use disorders: a qualitative systematic review of randomised controlled trials. , 2005, Social science & medicine.

[30]  J. Alvidrez,et al.  Comparisons of patients with comorbid psychiatric and substance use disorders: implications for treatment and service delivery. , 2004, The American journal of psychiatry.

[31]  R. Drake,et al.  Benzodiazepine use and abuse among patients with severe mental illness and co-occurring substance use disorders. , 2003, Psychiatric services.

[32]  T. Fong,et al.  Dual diagnosis and treatment compliance. , 2003, Psychiatric services.

[33]  M. Casas,et al.  Patología psiquiátrica asociada al alcoholismo , 2002 .

[34]  S. Santamarina,et al.  Esquizofrenia y sustancias psicotropas de consumo frecuente en nuestro medio , 2001 .

[35]  L. Domínguez.  Uso de neurolépticos atípicos en esquizofrénicos consumidores de cannabis , 2001 .

[36]  K. Carey,et al.  Treating substance abuse in the context of severe and persistent mental illness: clinicians' perspectives. , 2000, Journal of substance abuse treatment.

[37]  A. Bellack,et al.  Substance abuse treatment for people with schizophrenia. , 1998, Addictive behaviors.

[38]  R. Kessler,et al.  Lifetime co-occurrence of DSM-III-R alcohol abuse and dependence with other psychiatric disorders in the National Comorbidity Survey. , 1997, Archives of general psychiatry.