title: Medical adherence to topical corticosteroid preparations prescribed for psoriasis: A systematic review.
abstract: OBJECTIVE
  Topical corticosteroids and corticosteroid combinations are the principal treatments in psoriasis. The aim of this study was to investigate published literature dealing with medical adherence to topical corticosteroid or corticosteroid combinations in patients with psoriasis.
  
  
  METHODS
  Systematic electronic searches in English language literature were done until September 2015 without publication date restriction.
  
  
  RESULTS
  We identified 11 studies consisting of five surveys, two prospective studies, one qualitative study, one mixed-method study, one register study, and one interventional study. Observation periods varied and rates of nonadherence ranged from 8% to 88.3%. The rates were reported by patients on eight nonvalidated scales and one validated scale, measured by medication weight in two studies, and in two studies rates of nonadherence were measured using prescription registers. Thirty-four multifactorial determinants of nonadherence were found. One designed intervention consisted of a disease management program, which improved adherence in the study period. Overall, the studies included were heterogeneous in design and had a high risk of bias.
  
  
  CONCLUSIONS
  To improve health outcome in topical treatment of psoriasis, further studies should be conducted addressing determinants of nonadherence and test interventions to improve adherence. Validated measurements of medical nonadherence, prescription registers, or medication-weight are needed.
authors.affiliation: a Department of Dermatology and Allergy Centre , Odense University Hospital , Odense C , Denmark.|b Centre for Innovative Medical Technology, Institute of Clinical Research, University of Southern Denmark , Odense C , Denmark.|c Dermatological Investigations Scandinavia , Odense C , Denmark.
authors.forename: Mathias Tiedemann
authors.initials: MT
authors.lastname: Svendsen
authors.affiliation: a Department of Dermatology and Allergy Centre , Odense University Hospital , Odense C , Denmark.|c Dermatological Investigations Scandinavia , Odense C , Denmark.
authors.forename: Flemming
authors.initials: F
authors.lastname: Andersen
authors.affiliation: d Leo Pharma , Ballerup , Denmark.
authors.forename: Jakob
authors.initials: J
authors.lastname: Hansen
authors.affiliation: e Research Unit of User Perspectives, Department of Public Health , University of Southern Denmark , Odense C , Denmark.
authors.forename: Helle
authors.initials: H
authors.lastname: Johannessen
authors.affiliation: a Department of Dermatology and Allergy Centre , Odense University Hospital , Odense C , Denmark.|b Centre for Innovative Medical Technology, Institute of Clinical Research, University of Southern Denmark , Odense C , Denmark.|c Dermatological Investigations Scandinavia , Odense C , Denmark.
authors.forename: Klaus Ejner
authors.initials: KE
authors.lastname: Andersen
mesh_terms: D000287:Administration, Topical; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D003879:Dermatologic Agents / Q000627:therapeutic use*; D006801:Humans; D011565:Psoriasis / Q000188:drug therapy*; D016903:Drug Monitoring
chemical_list: D000305:Adrenal Cortex Hormones; D003879:Dermatologic Agents
keywords: adherence; calcipotriol; corticosteroid; psoriasis