Interventions to increase adherence to acne treatment

Sara Moradi Tuchayi, Tiffany M Alexander, Anish Nadkarni, Steven R Feldman, Sara Moradi Tuchayi, Tiffany M Alexander, Anish Nadkarni, Steven R Feldman

Abstract

Background: Adherence to acne medication is poor and is a major reason why treatment plans are ineffective. Recognizing solutions to nonadherence is critical.

Objective: The purpose of this study is to describe the hurdles associated with acne nonadherence and to provide mechanisms on how to ameliorate them.

Methods: PubMed database was searched. Of the 419 search results, 29 articles were reviewed to identify hurdles to adherence and corresponding solutions.

Results: Hurdles to primary nonadherence where the medication is not even started, include lack of knowledge, confusion about usage, weak physician-patient relationship, fear of adverse reactions, and cost. Secondary nonadherence hurdles where the medication is started but is not taken as directed include lack of results, complex regimens, side effects, busy lifestyle, forgetfulness, inconvenience, and psychiatric comorbidity. Solutions to these hurdles include treatment simplification, technology, and dynamic education.

Limitations: Adherence is affected by numerous factors, but available literature analyzing acne adherence and interventions to improve adherence to treatment is limited.

Conclusion: There are several hurdles in adhering to acne treatment. Recognition of these hurdles and finding appropriate solutions may be as important to treatment outcomes as choosing the right medication to prescribe.

Keywords: acne vulgaris; adherence; clinic visit; disease severity; lifestyle; pathogenesis; physician–patient relationship; prevalence; quality of life; treatment.

Conflict of interest statement

Dr Feldman is a speaker for Janssen and Taro. He is a consultant and speaker for Galderma, Stiefel/GlaxoSmithKline, Abbott Labs, Leo Pharma Inc. Dr Feldman has received grants from Galderma, Janssen, Abbott Labs, Amgen, Stiefel/GlaxoSmithKline, Celgene, and Anacor. He is a consultant for Amgen, Baxter, Caremark, Gerson Lehrman Group, Guidepoint Global, Hanall Pharmaceutical Co Ltd, Kikaku, Lilly, Merck & Co Inc, Merz Pharmaceuticals, Mylan, Novartis Pharmaceuticals, Pfizer Inc, Qurient, Suncare Research, and Xenoport. He is on an advisory board for Pfizer Inc. Dr Feldman is the founder and holds stock in Causa Research and holds stock and is majority owner in Medical Quality Enhancement Corporation. He receives Royalties from UpToDate and Xlibris. Sara Moradi Tuchayi, Tiffany Alexander, and Anish Nadkarni have no conflicts of interest to disclose.

References

    1. Lee DJ, Van Dyke GS, Kim J. Update on pathogenesis and treatment of acne. Curr Opin Pediatr. 2003;15(4):405–410.
    1. Timms RM. Moderate acne as a potential barrier to social relationships: myth or reality? Psychol Health Med. 2013;18(3):310–320.
    1. Revol O, Milliez N, Gerard D. Psychological impact of acne on 21st-century adolescents: decoding for better care. Br J Dermatol. 2015;172(Suppl 1):52–58.
    1. Tan X, Al-Dabagh A, Davis S, et al. Medication adherence, healthcare costs and utilization associated with acne drugs in Medicaid enrollees with acne vulgaris. Am J Clin Dermatol. 2013;14(3):243–251.
    1. Moradi Tuchai S, Makrantonaki E, Ganceviciene R, Dessinioti C, Feldman SR, Zouboulis CC. Acne vulgaris. Nat Rev Dis Primers. 2015;1:15029.
    1. Iuga AO, McGuire MJ. Adherence and health care costs. Risk Manag Healthc Policy. 2014;7:35–44.
    1. Anderson KL, Dothard EH, Huang KE, Feldman SR. Frequency of primary nonadherence to acne treatment. JAMA Dermatol. 2015;151(6):623–626.
    1. Baldwin HE. Tricks for improving compliance with acne therapy. Dermatol Ther. 2006;19(4):224–236.
    1. Ghaderi R, Saadatjoo A, Ghaderi F. Evaluating of life quality in patients with acne vulgaris using generic and specific questionnaires. Dermatol Res Pract. 2013;2013:1–5.
    1. Magin P, Heading G, Adams J, Pond D. Sex and the skin: a qualitative study of patients with acne, psoriasis and atopic eczema. Psychol Health Med. 2010;15(4):454–462.
    1. White GM. Recent findings in the epidemiologic evidence, classification, and subtypes of acne vulgaris. J Am Acad Dermatol. 1998;39(2 Pt 3):S34–S37.
    1. Dréno B, Thiboutot D, Gollnick H, et al. Large–scale worldwide observational study of adherence with acne therapy. Int J Dermatol. 2010;49(4):448–456.
    1. Tan X, Feldman SR, Chang J, Balkrishnan R. Topical drug delivery systems in dermatology: a review of patient adherence issues. Expert Opin Drug Deliv. 2012;9(10):1263–1271.
    1. Gorelick J, Daniels SR, Kawata AK, et al. Acne-related quality of life among female adults of different races/ethnicities. J Dermatol Nurses Assoc. 2015;7(3):154–162.
    1. Gollnick HP. From new findings in acne pathogenesis to new approaches in treatment. J Eur Acad Dermatol Venereol. 2015;29(Suppl 5):1–7.
    1. Aydemir EH. Acne vulgaris. Turk Pediatri Ars. 2014;49(1):13–16.
    1. Charakida A, Mouser PE, Chu AC. Safety and side effects of the acne drug, oral isotretinoin. Expert Opin Drug Saf. 2004;3(2):119–129.
    1. Penna P, Meckfessel MH, Preston N. Fixed-dose combination gel of adapalene and benzoyl peroxide plus doxycycline 100 mg versus oral isotretinoin for the treatment of severe acne: efficacy and cost analysis. Am Heal Drug Benefits. 2014;7(1):37–45.
    1. Thiboutot D, Dréno B, Layton A. Acne counseling to improve adherence. Cutis. 2008;81(1):81–86.
    1. Furue M, Onozuka D, Takeuchi S, et al. Poor adherence to oral and topical medication in 3096 dermatological patients as assessed by the Morisky medication adherence scale-8. Br J Dermatol. 2015;172(1):272–275.
    1. Rueda MJ. Acne subject preference for pump over tube for dispensing fixed-dose combination adapalene 0.1%-benzoyl peroxide 2.5% gel. Dermatol Ther (Heidelb) 2014;4(1):61–70.
    1. Renzi C, Picardi A, Abeni D, et al. Association of dissatisfaction with care and psychiatric morbidity with poor treatment compliance. Arch Dermatol. 2002;138(3):337–342.
    1. Sandoval LF, Semble A, Gustafson CJ, Huang KE, Levender MM, Feldman SR. Pilot randomized-control trial to assess the effect product sampling has on adherence using adapalene/benzoyl peroxide gel in acne patients. J Drugs Dermatol. 2014;13(2):135–140.
    1. Yentzer BA, Wood AA, Sagransky MJ, et al. An Internet-based survey and improvement of acne treatment outcomes. Arch dermatol. 2011;147(10):1223–1224.
    1. Boker A, Feetham HJ, Armstrong A, Purcell P, Jacobe H. Do automated text messages increase adherence to acne therapy? Results of a randomized, controlled trial. J Am Acad Dermatol. 2012;67(6):1136–1142.
    1. Miyachi Y, Hayashi N, Furukawa F, et al. Acne management in Japan: study of patient adherence. Dermatology. 2011;223(2):174–181.
    1. Feldman SR, Camacho FT, Krejci-Manwaring J, Carroll CL, Balkrishnan R. Adherence to topical therapy increases around the time of office visits. J Am Acad Dermatol. 2007;57(1):81–83.
    1. Yentzer BA, Gosnell AL, Clark AR, et al. A randomized controlled pilot study of strategies to increase adherence in teenagers with acne vulgaris. J Am Acad Dermatol. 2011;64(4):793–795.
    1. Webster GF. Acne vulgaris. BMJ. 2002;325(7362):475–479.

Source: PubMed

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