Abdel Hay Rania Mounir, Gad Leila Z, Ebeid Layla W, Elsherbini Youssef A, Elmetwally Ahmed A, Hussein Marwa Fathy, Beeharry Mohammad Yasine, AlOrbani Aya M
Dermatology Department, Faculty of Medicine, Cairo University, Kasr AlAiny Street, Cairo, 11562, Egypt.
Medical student, Cairo University, Cairo, Egypt.
Arch Dermatol Res. 2025 Mar 20;317(1):609. doi: 10.1007/s00403-025-03952-2.
Poor adherence contributes to worsening of medical conditions, increased medical costs, comorbidities and mortalities. Many factors may influence adherence in dermatology. Our aim was to study the degree of adherence of dermatology patients to topical and systemic medications and to identify the relationship of adherence to patient, disease, and treatment characteristics, as well as the influence of health care providers. Seven hundred and eighteen patients of both sexes with various dermatological complaints were included. They were all subjected to Morisky 8-item Medication Adherence Scale. Topical therapy was associated with a significantly lower adherence when compared to systemic therapy (P < 0.001). Adherence to systemic medication was superior for acute compared to chronic skin diseases (P = 0.008). Reduced adherence was also observed among uneducated patients, those facing financial difficulties, individuals prescribed complex topical regimens, and those using ointments Additional factors included insufficient instructions from physicians, perceived treatment effectiveness, and the experience of side effects. Patients with psoriasis and eczema showed the lowest adherence levels to both topical and systemic treatment. Overall, adherence of dermatology patients to treatment, particularly to topical treatment, was found to be unsatisfactory. Dermatologists should assess each patient's individual adherence barriers, and the management plan should be tailored according to many factors including the patient's financial status and educational level.
依从性差会导致病情恶化、医疗费用增加、合并症及死亡率上升。许多因素可能影响皮肤科的治疗依从性。我们的目的是研究皮肤科患者局部和全身用药的依从程度，确定依从性与患者、疾病及治疗特征之间的关系，以及医疗服务提供者的影响。纳入了718例有各种皮肤问题的男女患者。他们均接受了Morisky 8项药物依从性量表评估。与全身治疗相比，局部治疗的依从性显著更低（P < 0.001）。与慢性皮肤病相比，急性皮肤病患者对全身用药的依从性更好（P = 0.008）。在未受过教育的患者、面临经济困难的患者、接受复杂局部治疗方案的患者以及使用软膏的患者中也观察到依从性降低。其他因素包括医生指导不足、对治疗效果的认知以及副作用体验。银屑病和湿疹患者对局部和全身治疗的依从性最低。总体而言，发现皮肤科患者对治疗的依从性，尤其是对局部治疗的依从性不令人满意。皮肤科医生应评估每位患者个体的依从性障碍，管理计划应根据包括患者经济状况和教育水平在内的多种因素进行调整。
