Treatment compliance in patients with comorbid psychiatric and substance use disorders.
This study examines clinical and non-clinical factors associated with treatment compliance problems in 342 patients with substance use disorders (SUD) seen in routine psychiatric practice. Weighted Wald-X(2) and multivariate logistic regression assessed sociodemographic, clinical, treatment, and health plan characteristics associated with treatment compliance problems. Among patients with SUD, 40.5% were reported to currently have treatment compliance problems. Patients with treatment compliance problems were significantly more likely to have personality disorders, lower global assessment of functioning scores, and medication side effects than those without treatment compliance problems. Patients seen by psychiatrists who were reimbursed by discounted rather than undiscounted fee-for-service were five times more likely to be reported to have treatment compliance problems. Both clinical and non-clinical factors appear to be associated with treatment compliance problems. Understanding these factors and targeting treatment interventions may improve treatment compliance and patient outcomes.
Herbeck
Diane M
DM
University of California-Los Angeles Integrated Substance Abuse Programs, Los Angeles, CA 90025, USA. dherbeck@ucla.edu
Fitek
Diana J
DJ
Svikis
Dace S
DS
Montoya
Ivan D
ID
Marcus
Steven C
SC
West
Joyce C
JC
D000328:Adult; D000368:Aged; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000628:therapy*; D008875:Middle Aged; D010349:Patient Compliance; D010818:Practice Patterns, Physicians'; D011570:Psychiatry; D019966:Substance-Related Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000628:therapy*; D014481:United States