Introduction: Adherence is an important issue for health and health care systems. It can be defined as the correspondence between a person’s behaviour and the agreed upon recommendations from a care provider. Limited or nonadherence causes detriments for patients, their kin, the health care system and society. It is a particular social problem for homeless persons with substance use and psychiatric problems because throughout their life they accumulate risk factors in different life domains which impact their health and health care use. There is a need to gain more insight in the complexity of clinical, individual and social determinants of adherence of homeless persons in Brussels and Flanders with substance use and psychiatric problems.

Aim: This exploratory stage of the PhD research aims at scoping how adherence problems and risk factors for homeless people with psychiatric disorders and substance abuse are tackled in Brussels and Flanders. We aim to better understand the landscape of service providers (organisations) and professionals from different disciplines about care provision and adherence.

Methods: We performed a web search, document analysis and conducted exploratory semi-structured interviews (using topic lists) with professionals of health care organisations, social work and centres studying homelessness Transcripts of the interviews will be made and these will be coded. Data of different sources will be triangulated and thematically classified.

Results: The analysis will provide an overview of the perceived professional context-related barriers and facilitators for adherence. Findings will lead to a better understanding on the use of the adherence concept for this group and classifies barriers and facilitators according to the personal (including social network), professional, organisational, sectorial and health system related factors.

Discussion: This first exploratory phase is limited in its ambition to provide generalizable conclusions. Further in depth analysis of barriers will be done in a next step. Moreover, this phase focuses on the providers of care. In a next phase we will include the user perspective, using a life course approach which aims to understand the accumulation of risk factors for nonadherence during the life course by means of biographical interviews.
Original languageEnglish
Publication statusPublished - 20 Mar 2018
EventPhD day - VUB, Jette, Belgium
Duration: 20 Mar 201820 Mar 2018


ConferencePhD day

    Research areas

  • adherence, homeless persons, psychiatric disorders, substance use, Vulnerable Populations

ID: 36889055