Coordinated Treatment for Dual Diagnosis: Longer Treatment with Comparable Outcomes to Substance Use Disorder-Only Outpatients.

OBJECTIVE

This study aims to compare the process and outcome indicators of treatment between patients with dual diagnosis (DD) receiving coordinated care and those diagnosed with only substance use disorders (SUD) treated in addiction centers. It also aims to identify the impact of impact psychiatric comorbidity has on indicators of the therapeutic process and outcomes.

METHODS

Data were extracted from the electronic health records (HER) of 93,566 outpatients (5429 outpatients diagnosed with DD and 88,143 outpatients diagnosed with only SUD). The variables analyzed included sociodemographic data, therapeutic process indicators (time in treatment and number of appointments), and treatment outcomes.

RESULTS

No differences were found in terms of dropout/therapeutic discharge between the groups. However, patients in coordinated outpatient care exhibited a longer treatment duration (MDD = 19.82 vs. MSUD = 13.17; p < 0.001) and a greater number of follow-up appointments for therapeutic discharge (MDD = 23.84 vs. MSUD = 14.68; p < 0.001). In the regression analysis, the presence of comorbid mental disorders was identified as a significant predictor of both prolonged treatment duration and an increased number of follow-up appointments.

CONCLUSIONS

Patients receiving coordinated care with DD require greater use of resources from addiction centers (and probably from mental health services) than patients with only SUD to achieve their therapeutic goals. Thus, the greater use of healthcare resources by these patients indicates that coordinated care systems, although effective, may not be the most efficient.