de Lucas Raúl, Moreno-Arias Gerardo, Perez-López Montserrat, Vera-Casaño Ángel, Aladren Sonia, Milani Massimo
Hospital Universitario La Paz, Madrid, Spain.
Hospital Quirón Teknon, Barcelona, Spain.
BMC Dermatol. 2015 Sep 11;15:17. doi: 10.1186/s12895-015-0036-8.
In acne, several studies report a poor adherence to treatments. We evaluate, in a real-life setting conditions, the impact of compliance to physician's instructions, recommendations and adherence to the treatments on clinical outcome in patients with mild to moderate acne in an observational, non-interventional prospective study carried out in 72 Dermatologic Services in Spain (ACTUO Trial).
Six-hundred-forty-three subjects were enrolled and 566 patients (88 %) completed the 3 study visits. Study aimed to evaluate the impact of adherence (assessed with ECOB scale) on clinical outcome, as well as how the use of specific adjuvant treatments (facial cleansing, emollient, moisturizing and lenitive specific topical products) influences treatment's adherence and acne severity (0-5 points score). Recommendation of specific adjuvant skin barrier repair products was made in 85.2 %.
Overall, clinical improvement was observed throughout follow-up visits with an increased proportion of patients who reported reductions of ≥50 % on the total number of lesions (2 months: 25.2 %; 3 months: 57.6 %) and reductions of severity scores (2.5, 2.0 and 1.3 at 1, 2 and 3 months after treatment, respectively). Adherence to treatment was associated with a significant reduction on severity grading, a lower number of lesions and a higher proportion of patients with ≥50 % improvement.
Good adherence to medication plus adherence to adjuvants was significantly associated with a higher clinical improvement unlike those that despite adherence with medication had a low adherence to adjuvants. A good adherence to adjuvant treatment was associated with improved adherence and better treatment outcomes in mild to moderate acne patients. (ISRCTN Registry: ISRCTN14257026).
在痤疮治疗中,多项研究报告患者对治疗的依从性较差。在一项在西班牙72个皮肤科服务机构开展的观察性、非干预性前瞻性研究(ACTUO试验)中,我们在现实生活环境条件下,评估了遵循医生指示、建议以及坚持治疗对轻至中度痤疮患者临床结局的影响。
招募了643名受试者,566名患者(88%)完成了3次研究访视。研究旨在评估依从性(采用ECOB量表评估)对临床结局的影响,以及使用特定辅助治疗(面部清洁、润肤剂、保湿剂和舒缓特定外用产品)如何影响治疗依从性和痤疮严重程度(0 - 5分评分)。85.2%的患者接受了特定辅助皮肤屏障修复产品的推荐。
总体而言,在整个随访过程中观察到临床改善,报告皮损总数减少≥50%的患者比例增加(2个月时:25.2%;3个月时:57.6%),严重程度评分降低(治疗后1、2和3个月分别为2.5、2.0和1.3)。坚持治疗与严重程度分级显著降低、皮损数量减少以及改善≥50%的患者比例更高相关。
与那些尽管坚持用药但对辅助剂依从性低的患者不同,良好的药物依从性加上对辅助剂的依从性与更高的临床改善显著相关。在轻至中度痤疮患者中,良好的辅助治疗依从性与依从性改善和更好的治疗结局相关。(国际标准随机对照试验编号注册库:ISRCTN14257026)