Patel Nupur, Feldman Steven R
Department of Dermatology, Wake Forest University School of Medicine, Winston Salem, NC, USA.
Adv Exp Med Biol. 2017;1027:139-159. doi: 10.1007/978-3-319-64804-0_12.
Atopic dermatitis is a chronic dermatologic condition requiring extended treatment times with topical application of medications. While atopic dermatitis treatments can be highly effective when used as directed, oftentimes patients do not respond as expected, raising concern for non-adherence versus non-response. This chapter aims to describe what is currently known about adherence in atopic dermatitis and to discuss strategies to improve adherence in order to improve treatment outcomes. Whether intentional or unintentional, non-adherence to treatment can limit patient outcomes of this disease for a variety of reasons. These include frustration with medication efficacy, inconvenience, and fear of side effects. Other factors include forgetfulness, financial burden of treatment, lack of trust in the physician, dislike of prescribed medication, or lack of understanding of disease or treatment. Several interventions have been studied with the aim of improving adherence in atopic dermatitis-such as educational workshops for patients and caregivers, earlier follow-up visits, and text messages reminders-however these are often limited by sample size and power. Further research is needed to study both specific patterns of nonadherence in atopic dermatitis, as well as methods to improve them.
特应性皮炎是一种慢性皮肤病，需要长期局部用药治疗。虽然特应性皮炎治疗按医嘱使用时可能非常有效，但患者常常没有达到预期反应，这引发了对不依从与无反应的担忧。本章旨在描述目前已知的特应性皮炎治疗依从性情况，并讨论提高依从性以改善治疗效果的策略。无论有意还是无意，治疗不依从都会因多种原因限制该疾病患者的治疗效果。这些原因包括对药物疗效的失望、不便以及对副作用的恐惧。其他因素包括健忘、治疗费用负担、对医生缺乏信任、不喜欢所开药物或对疾病或治疗缺乏了解。为提高特应性皮炎治疗依从性，已经研究了多种干预措施，如为患者和护理人员举办教育讲习班、提前随访以及短信提醒等，但这些措施往往受到样本量和效能的限制。需要进一步研究特应性皮炎不依从的具体模式以及改善方法。
