Treatment adherence to treatment in substance users referred from Psychiatric Emergency service to outpatient treatment

Abstract

Objectives: The main objective was to evaluate the treatment adherence of patients attended at the Psychiatric Emergency Room and referred to an Outpatient Drug Clinic. Our aim was to describe the degree of adherence and the factors related to it.

Methods: A naturalistic study was conducted through examination of the clinical records of the patients attended in the Psychiatric Emergency Room of our hospital during one year (n=5052). Inclusion criteria consisted of substance dependence meeting DSM-IV criteria, belonging to our district, referral when discharged to an Outpatient Drug Clinic, and absence of previous treatment for Drug Addiction follow-ups (n=72). We evaluated further to the center link, adherence to the deviceduring the next year.

Results: 33.4% of the patients referred to an Outpatient Drug Clinic didn't request for a visit. From those who requested a first appointment, 20.83% didn't attend. From those who attended the first appointment, 47.37% abandoned treatment in the first 12 months. No differences between substance of use or time of the year of referral were observed.

Discussion: Independently to the accessibility to the Outpatient Clinic, difficulties in the adherence to drug addiction treatment exist. Inicial adherence to drug addiction treatment is medium. Patient's attendance to the clinics are important due to it's relation with retention doubling. Efforts should be made to improve the compliance with pharmacologic and nonpharmacologic treatment.