title: Non-adherence to topical treatments for actinic keratosis.
abstract: BACKGROUND
  There is limited information on the patterns of use, adherence rates, and factors that impact adherence with topical treatments for actinic keratosis (AK).
  
  
  OBJECTIVE
  To establish patterns of use and adherence with topical treatments for AK and to identify treatment-related factors that impact on adherence.
  
  
  METHODS
  A community-based, cross-sectional study was performed using a standardized questionnaire completed online or via telephone interview. Patients were stratified according to the presence of AK lesions on the scalp and/or other extremities; and presence of scarring resulting from treatment.
  
  
  RESULTS
  This study included 305 patients with AK who were currently using a patient-applied topical therapy for AK or had used one within the previous 12 months. In total, 88% (n = 268/305) of patients were either non-adherent, non-persistent or both non-adherent and non-persistent to topical therapy. Duration of treatment was associated with increasing rates of non-adherence (adjusted odds ratio [OR]; for treatment durations greater than 4 weeks, 2.2, P < 0.01): 52% of patients were non-adherent with 3-4 week treatment duration; 69% of patients with 4-8 week treatment duration; and 71% of patients with 6-12 week treatment duration. There were similar increases in non-persistence with increasing treatment duration (adjusted OR; for treatment durations greater than 4 weeks, 2.1, P < 0.05).
  
  
  CONCLUSIONS
  This study found high rates of non-adherence and non-persistence in patients with AK. Duration of treatment was a significant factor contributing to non-adherence and non-persistence to topical treatments. Patient-applied topical therapies that require less frequent application and have shorter treatment duration may be associated with improved adherence rates.
authors.affiliation: Department of Dermatology, Brighton and Sussex University Hospitals, Elm Grove, Brighton, UK.
authors.forename: Bav
authors.initials: B
authors.lastname: Shergill
authors.affiliation: Leo Pharma, Princes Risborough, London, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Zokaie
authors.affiliation: Hamell, London, UK.
authors.forename: Alison J
authors.initials: AJ
authors.lastname: Carr
keywords: chronic skin disease; patient behavior; patient compliance; treatment duration