Ahn Christine S, Culp Leonora, Huang William W, Davis Scott A, Feldman Steven R
a Department of Dermatology , Center for Dermatology Research, Wake Forest School of Medicine , Winston-Salem , NC , USA.
b Pathology & Public Health Sciences, Wake Forest School of Medicine , Winston-Salem , NC , USA.
J Dermatolog Treat. 2017 Mar;28(2):94-103. doi: 10.1080/09546634.2016.1181256. Epub 2016 May 15.
Non-adherence to treatment and medical recommendations is one of the leading causes of treatment failure, poor clinical outcomes, and increased healthcare utilization. Although non-adherence is observed across all medical specialties, adherence to treatment in dermatology deserves special attention given the multiple different routes of treatment. Adherence can be measured using subjective methods (patient reporting and questionnaires) or objective methods (pill counts, electronic chips, and pharmacy records). Adherence to dermatologic treatments varies based on the specific condition but is poor for systemic therapies and even worse with topical agents. Among the factors that influence adherence, duration of treatment, complexity of regimen, and access play a large role. Interventions to improve adherence can range from simplifying treatment regimens to scheduling more frequent office visits. Due to the profound effect on cost, healthcare outcomes, and mortality, understanding and improving adherence is equally as important as making the correct diagnosis and prescribing the correct treatment.
不遵守治疗和医学建议是治疗失败、临床结果不佳以及医疗保健利用率增加的主要原因之一。尽管在所有医学专科中都存在不遵守治疗的情况，但鉴于皮肤科有多种不同的治疗途径，皮肤科治疗的依从性值得特别关注。依从性可以通过主观方法（患者报告和问卷调查）或客观方法（药丸计数、电子芯片和药房记录）来衡量。皮肤科治疗的依从性因具体病情而异，但全身治疗的依从性较差，局部用药的依从性更差。在影响依从性的因素中，治疗持续时间、治疗方案的复杂性和可及性起着很大作用。改善依从性的干预措施范围从简化治疗方案到安排更频繁的门诊就诊。由于对成本、医疗保健结果和死亡率有深远影响，理解和提高依从性与做出正确诊断和开出处方同样重要。
