Background: Patients are commonly nonadherent to medication regimens. In derm atology, there has been little study of the effect of nonadherence on outcomes. Objectives: To test the association between adherence behav...Background: Patients are commonly nonadherent to medication regimens. In derm atology, there has been little study of the effect of nonadherence on outcomes. Objectives: To test the association between adherence behaviour and changes in s everity of psoriasis. Methods: Twenty-four subjects with psoriasis were enroll ed in an 8- week, left/right, controlled trial of salicylic acid plus topical t acrolimus ointment vs. salicylic acid plus placebo. Subjects were given salicyli c acid to apply to all lesions. The salicylic acid was supplied in a bottle with a medication event monitoring system cap in order to assess adherence to the sa licylic acid. The primary outcome for this study was the relationship between th e change in the disease severity (change in sum score of erythema, scale and thi ckness scores for a target plaque) and medication adherence. Results: The mean i nitial disease severity was 5- 8 on a nine-point sum score scale. For the top ical tacrolimus-treated side, a decrease in adherence rate of 10% was associ ated with a 1- point increase in severity (P < 0.05). For the placebo-treated side, adherence was not significantly correlated with changes in severity. Conc lusions: Nonadherence may have a significant role in altering clinical trial dat a, skewing it towards ineffectiveness. Improved outcomes in psoriasis may be ach ievable through interventions that improve patients’adherence to treatment.展开更多
文摘Background: Patients are commonly nonadherent to medication regimens. In derm atology, there has been little study of the effect of nonadherence on outcomes. Objectives: To test the association between adherence behaviour and changes in s everity of psoriasis. Methods: Twenty-four subjects with psoriasis were enroll ed in an 8- week, left/right, controlled trial of salicylic acid plus topical t acrolimus ointment vs. salicylic acid plus placebo. Subjects were given salicyli c acid to apply to all lesions. The salicylic acid was supplied in a bottle with a medication event monitoring system cap in order to assess adherence to the sa licylic acid. The primary outcome for this study was the relationship between th e change in the disease severity (change in sum score of erythema, scale and thi ckness scores for a target plaque) and medication adherence. Results: The mean i nitial disease severity was 5- 8 on a nine-point sum score scale. For the top ical tacrolimus-treated side, a decrease in adherence rate of 10% was associ ated with a 1- point increase in severity (P < 0.05). For the placebo-treated side, adherence was not significantly correlated with changes in severity. Conc lusions: Nonadherence may have a significant role in altering clinical trial dat a, skewing it towards ineffectiveness. Improved outcomes in psoriasis may be ach ievable through interventions that improve patients’adherence to treatment.
