Therapeutic Adherence Promotion Program for Severe Mental Illness: The ADHERA Study Protocol

Treatment adherence can improve the prognosis of severe mental illnesses. Self-report questionnaires are the main tools to measure it. However, a new assessment method has emerged: the electronic prescription system. This enables us to verify whether patients have collected their medication from the pharmacy, providing an objective measure of adherence. The ADHERA study aims to: (1) Compare digital self-report questionnaires with the electronic prescription system. (2) Identify factors associated with non-adherence. (3) Evaluate the effectiveness of an adherence-promoting intervention. This intervention will consist of the identification of patients with poor adherence and a subsequent program of psychoeducation led by clinical psychologists. Adherence will be reassessed six months later to evaluate the intervention's effectiveness. By identifying key sociodemographic and clinical factors associated with non-adherence, this project will inform targeted interventions to support patients with schizophrenia and bipolar disorder. Furthermore, the psychoeducational telehealth program may represent an effective, scalable, and patient-centered strategy to improve long-term treatment adherence and clinical outcomes. If successful, this model could be implemented in other regions and chronic conditions, contributing to a more efficient and patient-focused healthcare system.