Saeki Hidehisa, Imafuku Shinichi, Abe Masatoshi, Shintani Yoichi, Onozuka Daisuke, Hagihara Akihito, Katoh Norito, Murota Hiroyuki, Takeuchi Satoshi, Sugaya Makoto, Tanioka Miki, Kaneko Sakae, Masuda Koji, Hiragun Takaaki, Inomata Naoko, Kitami Yuki, Tsunemi Yuichiro, Abe Shinya, Kobayashi Miwa, Morisky Donald E, Furue Masutaka
Department of Dermatology, Nippon Medical School, Tokyo, Japan.
J Dermatol. 2015 Apr;42(4):367-72. doi: 10.1111/1346-8138.12804. Epub 2015 Feb 27.
Previously we assessed the medication adherence for oral and topical remedies by a translated Japanese version of the Morisky Medication Adherence Scale-8 (MMAS-8) together with socioeconomic backgrounds in 3096 Japanese dermatological patients, and found the medication adherence, especially to topical drugs, was poor in these patients. In order to elucidate the disease-specific sociomedical factors, we further sub-analyzed the medication adherence in 237 psoriasis patients and compared it with that in other dermatological diseases such as atopic dermatitis, urticaria or tinea. This study was conducted among patients registered in monitoring system and 3096 eligible patients were enrolled. Our web-based questionnaire included the following items such as age, sex, annual income, main health-care institution, experience of effectiveness by oral or topical medication, overall satisfaction with treatment, and MMAS-8 for oral or topical medication. Mean adherence score by MMAS-8 was 5.2 for oral and 4.3 for topical medication. More patients with psoriasis used a university hospital and fewer used a private clinic compared with those with the other skin disease patients. Experience of drug effectiveness by oral medication and overall satisfaction with treatment was lower in psoriasis patients than in other patients. In oral medication, significantly better adherence was observed in those of higher age and with higher annual income. The adherence to medication, especially to topical drugs, was poor in 237 psoriasis patients. We speculated that some severe psoriasis patients were not sufficiently treated systemically and were resistant to topical therapy, leading to poor adherence.
此前，我们通过翻译后的日语版莫里西药物依从性量表8（MMAS-8）以及社会经济背景，对3096名日本皮肤科患者口服和外用药物的依从性进行了评估，发现这些患者的药物依从性，尤其是外用药物的依从性较差。为了阐明特定疾病的社会医学因素，我们进一步对237名银屑病患者的药物依从性进行了亚分析，并将其与其他皮肤病如特应性皮炎、荨麻疹或癣的患者进行了比较。本研究在监测系统登记的患者中进行，共纳入3096名符合条件的患者。我们基于网络的调查问卷包括以下项目，如年龄、性别、年收入、主要医疗机构、口服或外用药物的疗效体验、对治疗的总体满意度以及口服或外用药物的MMAS-8。MMAS-8的口服药物平均依从性得分为5.2，外用药物为4.3。与其他皮肤病患者相比，银屑病患者更多地使用大学医院，更少地使用私人诊所。银屑病患者口服药物的疗效体验和对治疗的总体满意度低于其他患者。在口服药物方面，年龄较大和年收入较高的患者依从性明显更好。237名银屑病患者的药物依从性，尤其是外用药物的依从性较差。我们推测，一些重度银屑病患者没有得到充分的系统治疗，并且对局部治疗有抗性，导致依从性差。
