RESUMO
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.
Assuntos
Fármacos Dermatológicos/administração & dosagem , Adesão à Medicação/psicologia , Dermatopatias/tratamento farmacológico , Administração Cutânea , Fármacos Dermatológicos/uso terapêutico , Esquema de Medicação , Monitoramento de Medicamentos/métodos , Humanos , Adesão à Medicação/estatística & dados numéricos , Visita a Consultório Médico , Dermatopatias/psicologia , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Topical retinoids are first-line treatment options for acne vulgaris. These drugs, however, produce varying degree of cutaneous irritation within the first few weeks of treatment. OBJECTIVE: Our purpose was to examine differences in tolerability of topical retinoids and assess whether these differences would be clinically meaningful. METHODS: A PubMed search was performed for sources on topical retinoids in acne vulgaris treatment. Thirty-four clinical studies were analyzed. RESULTS: Thirteen studies had statistically significant results on tolerability of retinoid based on retinoid, vehicle, concentration, or skin type. All studies classified most of skin reactions as mild-moderate. Large differences in the number of dropouts due to irritation were not identified. CONCLUSION: Irritation studies did not show a high frequency of clinically significant irritation with topical retinoids. We anticipate that the large variation in patient use of topical retinoids would likely account for more variation in response than differences between drug formulations.