Perception of Spanish professionals on therapeutic adherence of dual diagnosis patients

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.

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).

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.

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.