Problems in Primary Care: treatment and adherence

Abstract

When discussing anxiety and mood disorders, which are the most frequent in primary care services, there are two problems regarding their treatment. The first one is the lack of controlled, evidence-based studies that seek to implement an empirically validated psychological treatment in Primary Care. The second and most forgotten one, is the essential role that adherence plays, because without it there are neither treatment nor results.
To promote therapeutic adherence and, therefore, treatment effectiveness, interventions must be adapted to each patient and to his/her own way of experiencing the disorder. Adherence must be taken into account as well as the factors that have an influence on it, which in turn are interrelated. These factors have to do with the patient and his/her environment; the healthcare staff and health services; and factors related to the disorder as well as the treatment. A specific intervention is also required regarding the type of adherence required and its strongest supportive pillar.
Future investigations should provide more detailed information about the reasons underlying attrition in order to improve the adherence and thus optimize treatment effectiveness.