title: To follow or not to follow dermatological treatment--a review of the literature.
abstract: Creams, ointments and solutions applied to the skin surface by patients as part of a daily routine might be expected to provide a more variable dosage than do standard tablets. However, adherence to treatment in dermatology has been little studied. This article reviews recent publications in the field. These are dominated by questionnaire-based studies, which tend to over-estimate adherence. Reduced adherence to dermatological treatment is noted in 34-45% of patients. It is likely that the percentage of patients who practice truly optimal treatment in their daily life is even lower considering the variable practice of self-treatment. Self-reported psychiatric morbidity contributes to poor adherence to dermatological treatment, while a well-functioning doctor-patient interaction is a major determinant of good adherence, as is patient satisfaction. In conclusion, adherence to dermatological treatment is unsatisfactory and there is a need for intervention and change in clinical routines. The therapeutic and economic benefits may be considerable. The immediate challenge is to stimulate a change in patient behaviour and improve self-treatment at home.
authors.affiliation: Department of Dermatology, Linköping University Hospital, Sweden. JS16@bbh.hosp.dk
authors.forename: Jørgen
authors.initials: J
authors.lastname: Serup
authors.forename: Asa Kettis
authors.initials: AK
authors.lastname: Lindblad
authors.forename: Marianne
authors.initials: M
authors.lastname: Maroti
authors.forename: Karin I
authors.initials: KI
authors.lastname: Kjellgren
authors.forename: Eva
authors.initials: E
authors.lastname: Niklasson
authors.forename: Lena
authors.initials: L
authors.lastname: Ring
authors.forename: Johan
authors.initials: J
authors.lastname: Ahlner
mesh_terms: D000279:Administration, Cutaneous; D015986:Confounding Factors, Epidemiologic; D003880:Dermatology; D006801:Humans; D007641:Keratolytic Agents / Q000008:administration & dosage*; D010349:Patient Compliance; D012871:Skin Diseases / Q000188:drug therapy*; D011795:Surveys and Questionnaires
chemical_list: D007641:Keratolytic Agents