Adult patients with alopecia areata report a significantly better medication adherence compared to those with atopic dermatitis: Results from a large cross-sectional cohort study
Mischa J. Mallbris , Lea Krog Nymand BS , Yuki Maria Fukuda Andersen MD, PhD , Alexander Egeberg MD, PhD
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Abstract
Background
Alopecia areata (AA) and atopic dermatitis (AD) are chronic skin diseases where the suboptimal medication adherence (MA) may result in poor clinical outcomes.
Objective
To assess the impact of AA on MA among adults compared to AD.
Methods
Patient reported MA of adults with AA were compared with AD. Patients were identified from the Danish Skin Cohort, a nationwide prospective cohort of dermatological patients in Denmark. We used the Medication Adherence Report Scale- 5, a self-reporting questionnaire, to assess MA. Demographic and disease characteristics were collected. Logistic regression was conducted.
Results
Patients with AA reported higher MA than AD (mean 21.81 vs 18.29). Logistic regression analyses showed AA diagnosis had a statistically significant positive effect on MA (odds ratio = 3.94, 95% CI 2.01-8.89). Men reported significantly higher MA (odds ratio = 1.49, 95% CI 1.14-1.94). Current disease severity did not impact MA.
Limitations
Data were self-reported by patients. Data regarding the specific treatment undergone by patients were not available.
Conclusion
Patients with AA have significantly higher MA compared to patients with AD. The stability of AA patients’ symptoms may lead to higher MA due to a desire for disease control. Conversely, the sporadicity of AD symptoms could negatively affect adherence, causing fluctuations in medication use.
背景斑秃(AA)和特应性皮炎(AD)都是慢性皮肤病,不理想的用药依从性(MA)可能会导致不良的临床结果。方法将成人斑秃患者报告的 MA 与成人特应性皮炎患者报告的 MA 进行比较。患者是从丹麦皮肤队列(Danish Skin Cohort)中确定的,该队列是丹麦全国范围内皮肤病患者的前瞻性队列。我们使用自我报告问卷 "用药依从性报告量表-5 "来评估用药依从性。我们还收集了人口统计学特征和疾病特征。结果AA患者的MA值高于AD患者(平均值为21.81 vs 18.29)。逻辑回归分析表明,AA 诊断对 MA 有统计学意义上的积极影响(几率比 = 3.94,95% CI 2.01-8.89)。男性报告的 MA 明显更高(几率比 = 1.49,95% CI 1.14-1.94)。目前的疾病严重程度对 MA 没有影响。结论与 AD 患者相比,AA 患者的 MA 明显更高。AA患者症状的稳定性可能会导致患者希望控制病情,从而提高MA值。相反,AD 症状的不稳定性可能会对患者的用药依从性产生负面影响,导致用药量波动。