Poor compliance with topical corticosteroids for atopic dermatitis despite severe disease.
ABSTRACT Electronic monitoring of adherence provides opportunities for new insights into the relationship between adherence and treatment outcomes. We report a patient who was non-adherent to treatment despite a high degree of atopic dermatitis severity. Such patients may be better managed by measures that increase adherence rather than use of more potent, potentially toxic medications.
SourceAvailable from: Kyu Han Kim[Show abstract] [Hide abstract]
ABSTRACT: Providing an educational program as part of a health care program for the management of atopic dermatitis (AD) patients has rapidly become popular. AD educational programs can be of benefit in measured outcomes for both dermatology specialists and patients. To determine the effects of programmed education delivered by dermatology specialists on the management and knowledge of AD, we assessed the effectiveness of patient/parental education at improving AD knowledge, and determined the usefulness of the education. The program consisted of five, 20-minutes sessions which were prepared, discussed, reviewed, and delivered by professors of dermatology. At the end of the program, AD knowledge was assessed using a standardized questionnaire. A total of 148 people were included. Fifty-eight patients/parents received the programmed education and the remaining 90 did not receive the programmed education. The mean questionnaire scores from both groups were compared. Mean knowledge scores were significantly higher for those who received the education (p=0.00). We analyzed the knowledge score according to factors such as gender, education level, marital status, and occupation. The data indicated that education level influences the subjects' knowledge level of AD, but gender, occupation, and marital status do not. An educational program can be an effective tool to improve patient quality of life and treatment compliance by providing psychological support to the patients and their parents.Annals of Dermatology 02/2014; 26(1):66-72. DOI:10.5021/ad.2014.26.1.66 · 0.95 Impact Factor
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ABSTRACT: Introduction and objectivesTo evaluate health-related quality of life (HRQOL), patient satisfaction, and adherence to treatment in patients with moderate or severe atopic dermatitis on maintenance therapy.Material and methodsWe performed a national, multicenter, cross-sectional, epidemiological study in adults and children with moderate or severe atopic dermatitis of at least 16 months’ duration who were receiving maintenance therapy. We used the Dermatology Life Quality Index (DLQI), the children's version of this scale (cDLQI), and the Morisky medication adherence scale. Visual analog scales were used to measure treatment satisfaction. We used the Mann-Whitney U test to compare HRQOL between patients with moderate and severe disease and the Wilcoxon test to compare the frequency and duration of flares before and after the start of maintenance therapy.ResultsWe studied 141 children and 141 adults; the prevalence of moderate AD in these groups was 85.8% and 79.4%, respectively. The impact of AD on HRQOL was mild to moderate. Maintenance therapy led to a significant decrease in the frequency and duration of flares (P < .001). While treatment satisfaction was high in both groups, adherence was poor (18.4%-42.6% in children and 14.9%-27.0% in adults).Conclusions Patients with moderate and severe AD receiving maintenance therapy experience a reduction in the number and duration of flares and an improvement in HRQOL. While treatment satisfaction is high, adherence rates could be improved.Actas Dermo-Sifiliográficas 06/2013; 104(5):409–417. DOI:10.1016/j.ad.2012.12.003
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ABSTRACT: Vitiligo is a pigmentary disorder associated with many disease conditions that necessitates multiple drug regimens, which make the treatment complicated. This stigmatic disease forces the patient to approach all system of medicines as well as alternative medicines of non proven value, which further worsens the situation. At the same time the nonadherence to the treatment reflects poor prognosis, which is misunderstood for lack of response resulting in poor faith to the medications. The aim of this work was to assess the patient compliance and the factors affecting, and to monitor the adverse effects as well as drug interactions. The study was carried out in the Institute of Applied Dermatology for a period of one year. Patient compliance was assessed using Morisky Medication Adherence Scale and found that 71% of the patients were low adherent to medications. Family support, faith in doctor, higher educational status and effectiveness of the treatment were some of the reasons for medication adherence whereas forgetfulness, feasibility, occupational problem, polypharmacy, longer duration of treatment and the feeling that the disease under is control were some of the reasons listed for nonadherence. Three adverse reactions were reported with narrow band ultraviolet B and topical tacrolimus therapy and they were categorized into possible and probable according to causality assessment by Naranjo scale. Five drug interactions were reported and the causality assessment was done using drug interaction probability scale. None of the reactions were serious or life threatening. The present study revealed the hurdles in providing safe and effective treatment to the patients and also it suggest the need of doing more research on this disease since there is a general belief that vitiligo is an incurable disease.Indian Journal of Pharmaceutical Sciences 12/2015; 77(1):8-13. · 0.30 Impact Factor