Krejci-Manwaring Jennifer, Tusa Mark G, Carroll Christie, Camacho Fabian, Kaur Mandeep, Carr David, Fleischer Alan B, Balkrishnan Rajesh, Feldman Steven R
Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1071, USA.
J Am Acad Dermatol. 2007 Feb;56(2):211-6. doi: 10.1016/j.jaad.2006.05.073. Epub 2006 Nov 13.
Atopic dermatitis is a common problem for which topical agents are the primary treatment. When topical medications fail, further therapy may include systemic agents with the potential for greater toxicity. Adherence to topical treatment of atopic dermatitis has not been well characterized. Poor adherence to topical medication could account for failure of topical therapy.
To determine adherence to topical treatment in patients with atopic dermatitis.
Thirty-seven children were given 0.1% triamcinolone ointment and were counseled to use it twice daily. They were told to return in 4 weeks, at which time they were told to continue treatment for another 4 weeks. Electronic monitors were used to measure adherence over the entire 8 week study. Patients were not informed of the compliance monitoring until the end of the study.
Twenty-six patients completed 8 weeks of treatment. Mean adherence from the baseline to the end of the study was 32%. Adherence was higher on or near office visit days and subsequently decreased rapidly.
This study was limited by the large number of subjects who failed to return for follow-up appointments or withdrew from the study.
Adherence to topical medications is very poor in a clinic population of children with atopic dermatitis. Office visits are one means to increase adherence. If adherence to topical treatment can be improved, exposure to more costly and potentially toxic systemic agents may be avoidable.
特应性皮炎是一个常见问题，局部用药是主要治疗方法。当局部用药无效时，进一步治疗可能包括毒性更大的全身性药物。特应性皮炎局部治疗的依从性尚未得到充分描述。局部用药依从性差可能是局部治疗失败的原因。
确定特应性皮炎患者局部治疗的依从性。
37名儿童被给予0.1%曲安奈德软膏，并建议每日使用两次。告知他们4周后复诊，届时再告知他们继续治疗4周。在整个8周的研究中使用电子监测器测量依从性。直到研究结束患者才被告知有依从性监测。
26名患者完成了8周的治疗。从基线到研究结束的平均依从性为32%。在复诊日或复诊日前后依从性较高，随后迅速下降。
本研究受到大量未返回进行随访预约或退出研究的受试者的限制。
在临床的特应性皮炎儿童群体中，局部用药的依从性非常差。复诊是提高依从性的一种方法。如果能提高局部治疗的依从性，或许可以避免使用更昂贵且有潜在毒性的全身性药物。
