Halioua B
Institut Alfred-Fournier, 25 boulevard Saint-Jacques, Paris, France.
Ann Dermatol Venereol. 2012 Jan;139 Suppl 1:S1-6. doi: 10.1016/S0151-9638(12)70101-1.
Taking into account topical treatment compliance is extremely important given its fundamental place in the dermatologist's armamentarium. After reviewing the definition of compliance, adherence, alliance, and clinical inertia, the direct methods used to measure compliance with a topical treatment (counting tubes administered, MEMS system performance, measuring circulating blood or urine rate of a medication or its metabolite, and observation of medication intake by a third party) and indirect methods (questioning the patient, the dermatologist's opinion) will be reviewed. The question of frequency, more important than compliance in cases of topical treatments compared to systemic treatments, has given rise to controversial opinions. Six factors related to topical treatment that play a role in therapeutic compliance can be cited: the perception of efficacy, the feeling of harmlessness, the treatment's simplicity, the treatment's duration, the galenic formulation, and the cost.
考虑到局部治疗的依从性在皮肤科医生的治疗手段中占据着基础性地位,因此其极为重要。在回顾了依从性、坚持性、联盟以及临床惰性的定义之后,将对用于衡量局部治疗依从性的直接方法(计算用药管数、MEMS系统性能、测量药物或其代谢物的循环血液或尿液浓度以及第三方对药物摄入情况的观察)和间接方法(询问患者、皮肤科医生的意见)进行综述。与全身治疗相比,在局部治疗中频率问题比依从性更为重要,这引发了诸多有争议的观点。可以列举出与局部治疗相关且在治疗依从性方面发挥作用的六个因素:疗效感知、无害感、治疗的简易性、治疗持续时间、药剂配方以及成本。