Adherence to oral and topical medications among dermatology patients

Abstract

Poor adherence contributes to worsening of medical conditions, increased medical costs, comorbidities and mortalities. Many factors may influence adherence in dermatology. Our aim was to study the degree of adherence of dermatology patients to topical and systemic medications and to identify the relationship of adherence to patient, disease, and treatment characteristics, as well as the influence of health care providers. Seven hundred and eighteen patients of both sexes with various dermatological complaints were included. They were all subjected to Morisky 8-item Medication Adherence Scale. Topical therapy was associated with a significantly lower adherence when compared to systemic therapy (P < 0.001). Adherence to systemic medication was superior for acute compared to chronic skin diseases (P = 0.008). Reduced adherence was also observed among uneducated patients, those facing financial difficulties, individuals prescribed complex topical regimens, and those using ointments Additional factors included insufficient instructions from physicians, perceived treatment effectiveness, and the experience of side effects. Patients with psoriasis and eczema showed the lowest adherence levels to both topical and systemic treatment. Overall, adherence of dermatology patients to treatment, particularly to topical treatment, was found to be unsatisfactory. Dermatologists should assess each patient’s individual adherence barriers, and the management plan should be tailored according to many factors including the patient’s financial status and educational level.