Treatment adherence and beliefs about medicines among Egyptian vitiligo patients.
Vitiligo is a chronic disorder of depigmentation that has different treatment modalities, but patients' nonadherence is common. This study aimed to assess the influence of patients' medication beliefs on patients' adherence to topical, oral medications, and phototherapy in vitiligo. Between September 2015 and February 2016, 260 patients with vitiligo were asked to fill in the Beliefs about Medicines Questionnaire (BMQ) to assess their beliefs about therapy for vitiligo. Their adherence to the therapy was examined using the 8-item Morisky Medication Adherence Scale (MMAS-8).


RESULTS
The MMAS-8 scale and BMQ had good internal consistency (Cronbach's α = 0.78 and 0.66, respectively). Using Morisky's recommended cutoff point, 71% of patients were categorized as low or nonadherent to the scheduled therapy. Patients who perceived specific necessity of dermatological medicines significantly adhered to their therapy (OR 1.23; 95% CI 1.09, 1.38; p = 0.001) whereas patients who had specific concerns about the adverse effects exhibited significant low adherence (OR 0.65; 95% CI 0.56, 0.76; p < 0.001).


CONCLUSIONS
Positive beliefs about the necessity of medications in vitiligo do not necessarily reflect high adherence. Patients' adherence behavior is a multidimensional and dynamic process. The prolonged course of treatment, its cost, and unsatisfactory outcomes influenced the patients' adherence.
Department of Clinical Pharmacy, Faculty of Pharmacy, Assiut University, Egypt.
Mostafa A Sayed
MA
Ali
Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Assiut University, Egypt.
Doaa A E
DA
Abou-Taleb
Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Al Azhar University, Egypt.
Refaat Ragheb
RR
Mohamed
D000293:Adolescent; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003879:Dermatologic Agents / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D016527:Drug Costs; D004534:Egypt; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010465:Perception; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014820:Vitiligo / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics / Q000523:psychology; D055815:Young Adult
D003879:Dermatologic Agents
medication adherence; medication beliefs; questionnaire; vitiligo