Poor adherence, which is higher in chronic conditions such as acne, is associated with treatment failure. Yet half of acne patients are at risk of it, as shown by an recent international survey.1,2
Considering the huge burden of acne, a greater focus on increasing compliance with medical treatment is needed to improve clinical recovery.3
Adherence is essential for any acne treatment to be effective. However, poor adherence with treatment is the primary problem, particularly because of the high proportion of teenagers.1
The reasons for the high rate of poor adherence can be categorized into patient factors, physician factors, treatment-related issues, and disease characteristics.2
Acne has a few unavoidable characteristics that can be difficult for patients to accept:1,2
Poor medication adherence may be associated with several various factors.2-4
Hurdles to acne treatment adherence2,3
To optimize treatment adherence, it first needs to be quantified and measured. Several methods are available to assess adherence. A quick, effective, and approved tool that can be used in a clinical setting is the ECOB questionnaire described by Pawin et al (2009), in which adherence is considered poor if at least one answer is different from those expected. If a physician suspects poor adherence, it is important to investigate the reasons why it is suboptimal.
Considering the low rate of compliance with medical acne treatment and the associated risk of treatment failure, solutions for overcoming the hurdles have been developed. They lie in simplification, technology, and dynamic education.
Interventions to acne treatment hurdles2,3
An essential component of acne management with positive effects on compliance is the appropriate selection and use of skincare and cleansers.2
A recent observational, non-interventional prospective study was carried out in 72 Dermatology Departments in Spain (ACTUO Trial) with 643 acne patients. It showed that good adherence to adjuvants is associated with a 2.2-fold increase in the probability of compliance with topical pharmacological treatments, and with significant reductions in the severity and number of acne lesions. Investigators concluded that good adherence to adjuvant treatment was associated with positive treatment outcomes in mild to moderate acne patients.5
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