Most of the actions on the treatment adherence have their focus on the patient or in the medication (beliefs, behavior, education, psychological aspects, family support, simplifying the posology, reminders, and others) being in many cases complicated techniques and that have demonstrated low efficacy.
Few studies assess the aspects related to the doctor and it´s influence in the treatment adherence: Beliefs, expectations, perceptions, doctor-patient communication.
The aim of this study is to know the perception of the urologist in the treatment adherence in overactive bladder syndrome (OAB), the barriers and the reasons for non-adherence, as well as the perception regarding communication with the patient and, to know the changes in the perception of the urologist after reviewing a common non-interventionist educational training material for doctors and patients on aspects relate to medication adherence.

Cross-sectional, descriptive study of urologists who treat patients with OAB. Sample Purpose from the Spanish Association of Urology to obtain a proportional representation of urologist of all country.
Voluntary participation with a Web survey (22 questions and answers on a Likert scale). Delivery and review of educational material about treatment adherence: Doctor´s material and patient´s material to work with patients at office. This material contains main ideas on treatment adherence and a brief explanation of each one. For  doctors with advice on how to approach and communicate better the problem and, for patient on aspects related to overactive bladder, the chronicity of the disease, the expectations and encourage the doctor to ask questions about OAB and treatment considerations. A second Web survey was performed at 3 months.
Statistics: means and medians, absolute / relative frequencies. Statistical comparison of responses by McNemar.

440 urologists surveyed with an average of 43 years-old, 77% male, 94% come from non-private practice and with an average of 13 years in the specialty.
Urologist's perception of the degree of adherente to treatment is high (7/10). From Urologist point of view: Alterations in the taking of medication are more in relation to the omission of dose and the abandonment (4/5) than with the inadequate intake of the treatment.
Knowledge of the barriers: The beliefs of the patient regarding the disease and negative emotions influence in an important way in the adherence. The perception of the doctor regarding the efficacy of the treatment is high, being low in the perception of the patient's expectations.
The main reasons indicated by doctors for low adherence are unfulfilled expectations, fear of adverse effects and cost.
The degree of knowledge reported about the adherence is high (7/10), as well as the doctor's comfort to talk about these aspects in the office-interview (8/10).
The doctor-patient communication is one of the main aspects evaluated by the doctor to determine the adherence, related to the information on the efficacy, expectations and adverse reactions. Urologist's perception is that the patient understands the treatment after the consultation (80%), the expectations about it (57%), resolves their doubts (81%) and feels comfortable to expose the issues (74%).

Most of the treated aspects were improved after the doctor's review and the discussion of the material with the patient: It increases the feeling of the degree of treatment adherence, it diminishes the sensation of forgetting in the taking of medicines, of forgetting doses or of abandoning it; increases the feeling of increased effectiveness, the degree of knowledge about adherence and realistic patient expectations.

Urologist's perception of the disease and its treatment is important for adherence in OAB. Doctors overestimate treatment adherence and tend to decrease importance about it. The active participation of the doctor and the adequate doctor-patient communication is one of the main aspects to improve adherence.