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Adherence in Atopic Dermatitis

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Treatment Adherence in Dermatology

Part of the book series: Updates in Clinical Dermatology ((UCD))

Abstract

Atopic dermatitis (AD) is a chronic inflammatory skin disease that begins in childhood and persists into adulthood. It has a huge impact on the quality of life of patients. Management of AD primarily involves topical therapies before a step up to systemic treatments. Nonadherence to treatment is a common issue as 30% of AD patients don’t take their medication as prescribed. It is important to identify reasons for nonadherence and implement effective interventions to overcome barriers to nonadherence. Frequently cited barriers include a fear of adverse effects, unclear treatment instructions, messy application, forgetfulness and high costs. Educational workshops, written action plans, early and frequent follow-up visits and reminder systems may help combat these barriers and improve adherence. Better adherence to treatment can lead to better treatment outcomes, quality of life and ease the economic burden.

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References

  1. Williams H, Robertson C, Stewart A, Ait-Khaled N, Anabwani G, Anderson R, et al. Worldwide variations in the prevalence of symptoms of atopic eczema in the International Study of Asthma and Allergies in Childhood. J Allergy Clin Immunol. 1999;103(1. Pt 1):125–38.

    Article  CAS  PubMed  Google Scholar 

  2. Shaw TE, Currie GP, Koudelka CW, Simpson EL. Eczema prevalence in the United States: data from the 2003 National Survey of Children’s Health. J Invest Dermatol. 2011;131(1):67–73.

    Article  CAS  PubMed  Google Scholar 

  3. Su JC, Kemp AS, Varigos GA, Nolan TM. Atopic eczema: its impact on the family and financial cost. Arch Dis Child. 1997;76(2):159–62.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Krejci-Manwaring J, Tusa MG, Carroll C, Camacho F, Kaur M, Carr D, et al. Stealth monitoring of adherence to topical medication: adherence is very poor in children with atopic dermatitis. J Am Acad Dermatol. 2007;56(2):211–6.

    Article  PubMed  Google Scholar 

  5. Storm A, Andersen SE, Benfeldt E, Serup J. One in 3 prescriptions are never redeemed: primary nonadherence in an outpatient clinic. J Am Acad Dermatol. 2008;59(1):27–33.

    Article  PubMed  Google Scholar 

  6. Zuberbier T, Orlow SJ, Paller AS, Taieb A, Allen R, Hernanz-Hermosa JM, et al. Patient perspectives on the management of atopic dermatitis. J Allergy Clin Immunol. 2006;118(1):226–32.

    Article  PubMed  Google Scholar 

  7. Yang MY, Jin H, Shim WH, Kim GW, Kim HS, Ko HC, et al. High rates of secondary non-adherence causes decreased efficacy of 0.1% topical tacrolimus in adult eczema patients: results from a multicenter clinical trial. J Dermatolog Treat. 2018;29(2):129–34.

    Article  CAS  PubMed  Google Scholar 

  8. Wilson R, Camacho F, Clark AR, Young T, Inabinet R, Yentzer BA, et al. Adherence to topical hydrocortisone 17-butyrate 0.1% in different vehicles in adults with atopic dermatitis. J Am Acad Dermatol. 2009;60(1):166–8.

    Article  PubMed  Google Scholar 

  9. Yentzer BA, Camacho FT, Young T, Fountain JM, Clark AR, Feldman SR. Good adherence and early efficacy using desonide hydrogel for atopic dermatitis: results from a program addressing patient compliance. J Drugs Dermatol. 2010;9(4):324–9.

    PubMed  Google Scholar 

  10. Conde JF, Kaur M, Fleischer AB Jr, Tusa MG, Camacho F, Feldman SR. Adherence to clocortolone pivalate cream 0.1% in a pediatric population with atopic dermatitis. Cutis. 2008;81(5):435–41.

    PubMed  Google Scholar 

  11. Hix E, Gustafson CJ, O'Neill JL, Huang K, Sandoval LF, Harrison J, et al. Adherence to a five day treatment course of topical fluocinonide 0.1% cream in atopic dermatitis. Dermatol Online J. 2013;19(10):20029.

    PubMed  Google Scholar 

  12. Fleischer DM, Udkoff J, Borok J, Friedman A, Nicol N, Bienstock J, et al. Atopic dermatitis: skin care and topical therapies. Semin Cutan Med Surg. 2017;36(3):104–10.

    Article  PubMed  Google Scholar 

  13. Huynh RK, Wong HH, Aw D, Toh M. Adherence to topical corticosteroids and moisturisers in adults with endogenous eczema in Singapore. Hong Kong J Dermatol Venereol. 2015;23:161–74.

    Google Scholar 

  14. Kraft JN, Lynde CW. Moisturizers: what they are and a practical approach to product selection. Skin Therapy Lett. 2005;10(5):1–8.

    CAS  PubMed  Google Scholar 

  15. Joergensen KM, Jemec GBE. Use of moisturizers among Danish atopic dermatitis patients-which perceived product characteristics associate with long-term adherence? J Dermatolog Treat. 2018;29(2):116–22.

    Article  PubMed  Google Scholar 

  16. Santer M, Muller I, Yardley L, Lewis-Jones S, Ersser S, Little P. Parents’ and carers’ views about emollients for childhood eczema: qualitative interview study. BMJ open. 2016;6(8):e011887.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Oranje AP, Devillers AC, Kunz B, Jones SL, DeRaeve L, Van Gysel D, et al. Treatment of patients with atopic dermatitis using wet-wrap dressings with diluted steroids and/or emollients. An expert panel's opinion and review of the literature. J Eur Acad Dermatol Venereol. 2006;20(10):1277–86.

    Article  CAS  PubMed  Google Scholar 

  18. Jin H, Kim JM, Kim GW, Kim HS, Ko HC, Kim MB, et al. Inappropriate amounts of topical tacrolimus applied on Korean patients with eczema. J Dermatolog Treat. 2017;28(4):327–31.

    Article  CAS  PubMed  Google Scholar 

  19. Lin CP, Gordon S, Her MJ, Rosmarin D. A retrospective study: application site pain with the use of crisaborole, a topical PDE4 inhibitor. J Am Acad Dermatol. 2018;80(5):1451–3.

    Google Scholar 

  20. Brown KK, Rehmus WE, Kimball AB. Determining the relative importance of patient motivations for nonadherence to topical corticosteroid therapy in psoriasis. J Am Acad Dermatol. 2006;55(4):607–13.

    Article  PubMed  Google Scholar 

  21. Feldman SR, Vrijens B, Gieler U, Piaserico S, Puig L, van de Kerkhof P. Treatment adherence intervention studies in dermatology and guidance on how to support adherence. Am J Clin Dermatol. 2017;18(2):253–71.

    Article  PubMed  Google Scholar 

  22. Fouere S, Adjadj L, Pawin H. How patients experience psoriasis: results from a European survey. J Eur Acad Dermatol Venereol. 2005;19(Suppl 3):2–6.

    Article  PubMed  Google Scholar 

  23. Ellis RM, Koch LH, McGuire E, Williams JV. Potential barriers to adherence in pediatric dermatology. Pediatr Dermatol. 2011;28(3):242–4.

    Article  PubMed  Google Scholar 

  24. Aubert-Wastiaux H, Moret L, Le Rhun A, Fontenoy AM, Nguyen JM, Leux C, et al. Topical corticosteroid phobia in atopic dermatitis: a study of its nature, origins and frequency. Br J Dermatol. 2011;165(4):808–14.

    Article  CAS  PubMed  Google Scholar 

  25. Gustavsen HE, Gjersvik P. Topical corticosteroid phobia among parents of children with atopic dermatitis in a semirural area of Norway. J Eur Acad Dermatol Venereol. 2016;30(1):168.

    Article  CAS  PubMed  Google Scholar 

  26. Savary J, Ortonne JP, Aractingi S. The right dose in the right place: an overview of current prescription, instruction and application modalities for topical psoriasis treatments. J Eur Acad Dermatol Venereol. 2005;19(Suppl 3):14–7.

    Article  PubMed  Google Scholar 

  27. Choi JW, Kim BR, Youn SW. Adherence to topical therapies for the treatment of psoriasis: surveys of physicians and patients. Ann Dermatol. 2017;29(5):559–64.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Fenerty SD, O'Neill JL, Gustafson CJ, Feldman SR. Maternal adherence factors in the treatment of pediatric atopic dermatitis. JAMA Dermatol. 2013;149(2):229–31.

    Article  PubMed  Google Scholar 

  29. Santer M, Burgess H, Yardley L, Ersser SJ, Lewis-Jones S, Muller I, et al. Managing childhood eczema: qualitative study exploring carers' experiences of barriers and facilitators to treatment adherence. J Adv Nurs. 2013;69(11):2493–501.

    PubMed  Google Scholar 

  30. Luersen K, Davis SA, Kaplan SG, Abel TD, Winchester WW, Feldman SR. Sticker charts: a method for improving adherence to treatment of chronic diseases in children. Pediatr Dermatol. 2012;29(4):403–8.

    Article  PubMed  Google Scholar 

  31. Grillo M, Gassner L, Marshman G, Dunn S, Hudson P. Pediatric atopic eczema: the impact of an educational intervention. Pediatr Dermatol. 2006;23(5):428–36.

    Article  PubMed  Google Scholar 

  32. Moore EJ, Williams A, Manias E, Varigos G, Donath S. Eczema workshops reduce severity of childhood atopic eczema. Australas J Dermatol. 2009;50(2):100–6.

    Article  PubMed  Google Scholar 

  33. Staab D, von Rueden U, Kehrt R, Erhart M, Wenninger K, Kamtsiuris P, et al. Evaluation of a parental training program for the management of childhood atopic dermatitis. Pediatr Allergy Immunol. 2002;13(2):84–90.

    Article  PubMed  Google Scholar 

  34. Shaw M, Morrell DS, Goldsmith LA. A study of targeted enhanced patient care for pediatric atopic dermatitis (STEP PAD). Pediatr Dermatol. 2008;25(1):19–24.

    Article  PubMed  Google Scholar 

  35. Chinn DJ, Poyner T, Sibley G. Randomized controlled trial of a single dermatology nurse consultation in primary care on the quality of life of children with atopic eczema. Br J Dermatol. 2002;146(3):432–9.

    Article  CAS  PubMed  Google Scholar 

  36. Stringer T, Yin HS, Oza VS. A survey to assess use patterns and perceptions of efficacy of eczema action plans among pediatric dermatologists. Pediatr Dermatol. 2018;35(6):e432–e4.

    Article  PubMed  Google Scholar 

  37. Rork JF, Sheehan WJ, Gaffin JM, Timmons KG, Sidbury R, Schneider LC, et al. Parental response to written eczema action plans in children with eczema. Arch Dermatol. 2012;148(3):391–2.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Gilliam AE, Madden N, Sendowski M, Mioduszewski M, Duderstadt KG. Use of Eczema Action Plans (EAPs) to improve parental understanding of treatment regimens in pediatric atopic dermatitis (AD): a randomized controlled trial. J Am Acad Dermatol. 2016;74(2):375–7.e1-3.

    Article  PubMed  Google Scholar 

  39. Lee E, Trepicchio WL, Oestreicher JL, Pittman D, Wang F, Chamian F, et al. Increased expression of interleukin 23 p19 and p40 in lesional skin of patients with psoriasis vulgaris. J Exp Med. 2004;199(1):125–30.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Pena-Robichaux V, Kvedar JC, Watson AJ. Text messages as a reminder aid and educational tool in adults and adolescents with atopic dermatitis: a pilot study. Dermatol Res Pract. 2010;2010:894258.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Singer HM, Levin LE, Morel KD, Garzon MC, Stockwell MS, Lauren CT. Texting atopic dermatitis patients to optimize learning and eczema area and severity index scores: a pilot randomized control trial. Pediatr Dermatol. 2018;35(4):453–7.

    Article  PubMed  Google Scholar 

  42. Feldman SR, Camacho FT, Krejci-Manwaring J, Carroll CL, Balkrishnan R. Adherence to topical therapy increases around the time of office visits. J Am Acad Dermatol. 2007;57(1):81–3.

    Article  PubMed  Google Scholar 

  43. Sagransky MJ, Yentzer BA, Williams LL, Clark AR, Taylor SL, Feldman SR. A randomized controlled pilot study of the effects of an extra office visit on adherence and outcomes in atopic dermatitis. Arch Dermatol. 2010;146(12):1428–30.

    Article  PubMed  Google Scholar 

  44. Song H, Adamson A, Mostaghimi A. Medicare Part D payments for topical steroids: rising costs and potential savings. JAMA Dermatol. 2017;153(8):755–9.

    Article  PubMed  PubMed Central  Google Scholar 

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Conflicts of Interest

Feldman has received research, speaking and/or consulting support from a variety of companies including Galderma, GSK/Stiefel, Almirall, Leo Pharma, Boehringer Ingelheim, Mylan, Celgene, Pfizer, Valeant, Abbvie, Samsung, Janssen, Lilly, Menlo, Merck, Novartis, Regeneron, Sanofi, Novan, Qurient, National Biological Corporation, Caremark, Advance Medical, Sun Pharma, Suncare Research, Informa, UpToDate and National Psoriasis Foundation. He is founder and majority owner of www.DrScore.com and founder and part owner of Causa Research, a company dedicated to enhancing patients’ adherence to treatment. Dr. Lindsay Strowd has received grant support from Pfizer, consulting support from Sandofi Regeneron Granzyme and is a speaker for Actelion.

Sree Kolli, Adrian Pona and Abigail Cline have no conflicts to disclose.

Author information

Authors and Affiliations

  1. Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA

    Sree S. Kolli, Adrian Pona & Abigail Cline

  2. Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA

    Lindsay C. Strowd

  3. Departments of Dermatology, Pathology and Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA

    Steven R. Feldman

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  1. Sree S. Kolli
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  2. Adrian Pona
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  3. Abigail Cline
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  4. Lindsay C. Strowd
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  5. Steven R. Feldman
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Correspondence to Sree S. Kolli .

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Editors and Affiliations

  1. Departments of Dermatology, Pathology and Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA

    Steven R. Feldman

  2. Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA

    Abigail Cline

  3. Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA

    Adrian Pona

  4. Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA

    Sree S. Kolli

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Kolli, S.S., Pona, A., Cline, A., Strowd, L.C., Feldman, S.R. (2020). Adherence in Atopic Dermatitis. In: Feldman, S., Cline, A., Pona, A., Kolli, S. (eds) Treatment Adherence in Dermatology. Updates in Clinical Dermatology. Springer, Cham. https://doi.org/10.1007/978-3-030-27809-0_8

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  • DOI: https://doi.org/10.1007/978-3-030-27809-0_8

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-030-27809-0

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