How can you improve treatment compliance in daily practice?

  • 15min
  • May. 2022
  • Supported by
    • La Roche-Posay

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



Compliance in acne: multiple hurdles


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

Poor medication adherence may be associated with several various factors.2-4


Hurdles to acne treatment adherence2,3



Optimizing treatment adherence: first quantify and measure2


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.



Improving compliance: there are solutions3


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

Appropriate skincare and cleansers: effective solutions to improve compliance and treatment outcomes


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


Bibliography

  1. Dreno B., Thiboutot D., Gollnick H., et al. Large-scale worldwide observational study of adherence with acne therapy. Int J Dermatol 2010;49:448–53.
    Link to abstract
  2. Thomas B., Tan J. K. L. Adherence Optimization in Acne Management. Skin therapy letter 2011
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  3. Tuchayi S.M., Alexander T.M., Nadkarni A., Feldman S.R. Interventions to increase adherence to acne treatment. Patient Preference and Adherence 2016;10:2091–6.
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  4. Park C., Kim G., Patel I., et al. Improving adherence to acne treatment: the emerging role of application software. Clin Cosmet Investig Dermatol. 2014:7:65–72.
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  5. de Lucas R., Moreno-Arias G., Perez-López M., et al. Adherence to drug treatments and adjuvant barrier repair therapies are key factors for clinical improvement in mild to moderate acne: the ACTUO observational prospective multicenter cohort trial in 643 patients. BMC Dermatol. 2015;15:17
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