Abraham Suja, Raghavan Padma
Department of Pharmacy Practice, Amrita School of Pharmacy, Amrita Viswavidyapeetham University, AIMS Healthscience Campus, Kochi-682 026, India.
Indian J Pharm Sci. 2015 Jan-Feb;77(1):8-13. doi: 10.4103/0250-474x.151573.
Vitiligo is a pigmentary disorder associated with many disease conditions that necessitates multiple drug regimens, which make the treatment complicated. This stigmatic disease forces the patient to approach all system of medicines as well as alternative medicines of non proven value, which further worsens the situation. At the same time the nonadherence to the treatment reflects poor prognosis, which is misunderstood for lack of response resulting in poor faith to the medications. The aim of this work was to assess the patient compliance and the factors affecting, and to monitor the adverse effects as well as drug interactions. The study was carried out in the Institute of Applied Dermatology for a period of one year. Patient compliance was assessed using Morisky Medication Adherence Scale and found that 71% of the patients were low adherent to medications. Family support, faith in doctor, higher educational status and effectiveness of the treatment were some of the reasons for medication adherence whereas forgetfulness, feasibility, occupational problem, polypharmacy, longer duration of treatment and the feeling that the disease under is control were some of the reasons listed for nonadherence. Three adverse reactions were reported with narrow band ultraviolet B and topical tacrolimus therapy and they were categorized into possible and probable according to causality assessment by Naranjo scale. Five drug interactions were reported and the causality assessment was done using drug interaction probability scale. None of the reactions were serious or life threatening. The present study revealed the hurdles in providing safe and effective treatment to the patients and also it suggest the need of doing more research on this disease since there is a general belief that vitiligo is an incurable disease.
白癜风是一种与多种疾病状况相关的色素沉着紊乱疾病，需要多种药物治疗方案，这使得治疗变得复杂。这种有污名化的疾病迫使患者尝试所有医学体系以及未经证实有价值的替代药物，这进一步恶化了病情。同时，不坚持治疗反映出预后不良，这被误解为缺乏疗效，导致对药物缺乏信心。这项工作的目的是评估患者的依从性及其影响因素，并监测不良反应和药物相互作用。该研究在应用皮肤病研究所进行了一年。使用莫里西药物依从性量表评估患者依从性，发现71%的患者药物依从性低。家庭支持、对医生的信任、较高的教育水平和治疗效果是坚持用药的一些原因，而健忘、可行性、职业问题、联合用药、治疗时间长以及认为疾病处于可控状态是列出的不依从的一些原因。窄谱中波紫外线和外用他克莫司治疗报告了3例不良反应，根据纳朗霍量表的因果关系评估将它们分为可能和很可能。报告了5例药物相互作用，并使用药物相互作用概率量表进行因果关系评估。没有反应是严重的或危及生命的。本研究揭示了为患者提供安全有效治疗的障碍，也表明需要对这种疾病进行更多研究，因为普遍认为白癜风是一种不治之症。
