title: Topical drug delivery systems in dermatology: a review of patient adherence issues.
abstract: BACKGROUND
  Until now, the main focus of medication adherence research has been oral drugs. Fewer studies have examined adherence to topical drugs. The issue of patient adherence to topical drugs is particularly significant in relation to chronic skin diseases, including psoriasis, atopic dermatitis, and acne, which require long-term use of topical medications.
  
  
  METHODS
  The authors reviewed the current evidence of adherence to topical therapy in dermatological diseases, mainly focusing on psoriasis, atopic dermatitis, and acne. The predictors or factors influencing adherence to topical therapy are then discussed. In general, the prevalence of poor adherence to topical drugs is high in dermatology. However, this research area remains empirically underdeveloped. We are still facing challenges in measuring topical medication adherence.
  
  
  CONCLUSIONS
  The authors recommend some possible ways to improve topical medication adherence and provide some future research directions. Taking patient preference into consideration in selecting the right topical delivery vehicle is particularly important in improving patient adherence. Better drug design, formulation, or technology may be another important direction. Other possible effective ways to improve topical medication adherence include good physician-patient relationship, patient education, individualized treatment plan, psychological intervention, electronic devices, and return visits.
authors.affiliation: University of Michigan, College of Pharmacy, Department of Clinical, Social and Administrative Sciences, Ann Arbor, MI, USA. tanxi@umich.edu
authors.forename: Xi
authors.initials: X
authors.lastname: Tan
authors.forename: Steven R
authors.initials: SR
authors.lastname: Feldman
authors.forename: Jongwha
authors.initials: J
authors.lastname: Chang
authors.forename: Rajesh
authors.initials: R
authors.lastname: Balkrishnan
mesh_terms: D000152:Acne Vulgaris / Q000188:drug therapy; D000287:Administration, Topical; D003876:Dermatitis, Atopic / Q000188:drug therapy; D016503:Drug Delivery Systems; D015195:Drug Design; D006801:Humans; D010349:Patient Compliance; D010817:Physician-Patient Relations; D011565:Psoriasis / Q000188:drug therapy; D012871:Skin Diseases / Q000188:drug therapy*