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Patient Prefer Adherence. 2016 Sep 19;10:1855-1868. eCollection 2016.

Professionals' perception on the management of patients with dual disorders.

Author information

1
Addiction and Dual Diagnosis Unit, CIBERSAM, Hospital Vall Hebron, Barcelona Public Health Agency (ASPB), Barcelona, Spain; Department of Psychiatry, Autonomous University of Barcelona, Barcelona, Spain.
2
Outpatient Mental Health Clinic El Retiro, Gregorio Marañón University Hospital, Madrid, Spain.
3
Outpatient Drug Clinic, Hospital San Juan de Dios, Palencia, Spain.
4
Pontevedra City Council Drug Dependence Service, Galician Health Service (Xunta de Galicia), Pontevedra, Spain.
5
Outpatient Drug Clinic Sants, Barcelona Public Health Agency (ASPB), Barcelona, Spain.
6
Medical Affairs Department, Janssen-Cilag S.A., Madrid, Spain.

Abstract

BACKGROUND:

There is a need to evaluate the professionals' perception about the consequences of the lack of therapeutic adherence in the evolution of patients with co-occurring disorders.

METHODS:

An online survey, released on the Socidrogalcohol [Spanish Scientific Society for Research on Alcohol, Alcoholism and other Drug Addictions] and Sociedad Española de Patología Dual [the Spanish Society of Dual Pathology] web pages, was answered by 250 professionals who work in different types of Spanish health centers where dual diagnosis patients are assisted.

RESULTS:

Most professionals perceived the existence of noncompliance among dual diagnosis patients. Almost all of these professionals (99%) perceived that noncompliance leads to a worsening of the progression of the patient's disorder, in both the exacerbation of mental disorders and the consumption of addictive substances. Most of the professionals (69.2%) considered therapeutic alliance as the main aspect to take into account to improve the prognosis in this population. The primary purpose of treatment must be the improvement of psychotic-phase positive symptoms, followed by the control of behavior disorders, reduction of craving, improvement of social and personal performances, and reduction of psychotic-phase negative symptoms.

CONCLUSION:

Most professionals perceived low adherence among dual diagnosis patients. This lack of adherence is associated with a worsening of their disease evolution, which is reflected in exacerbations of the psychopathology and relapse in substance use. Therefore, we propose to identify strategies to improve adherence.

KEYWORDS:

decompensation; dual diagnosis; noncompliance; professionals’ perception; relapse

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