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Scott A. Davis - Adherence in Dermatology

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Scott A. Davis Adherence in Dermatology
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An essential, comprehensive, and practical guide to understanding, measuring, and modifying patients adherence behavior to optimize treatment outcomes, this book covers all major aspects of adherence in dermatology. The first section describes current knowledge on the magnitude and impact of nonadherence; the second outlines measuring adherence in the context of databases, trials and practice. The third section addresses adherence in key skin diseases and the fourth covers numerous strategies to improve adherence by mitigating specific patient barriers. All sections emphasize ways to optimize communication with patients: the foundation for producing successful health behavior change. Low adherence helps explain why, despite effective treatments existing for all major dermatologic conditions, many patients still fail to improve. When clinicians endeavour to maximize adherence, with the aid of evidence-based strategies, these drugs will often realise their potential. This book devotes special attention to understanding why individuals may be nonadherent, so that each patient can receive a suitable treatment regimen, with a personalized plan of action. This book is designed for clinicians at all levels, serving as both introductory training for medical students and residents, and an update on the field for experienced practitioners. Researchers and policymakers will also benefit from its coverage of research methods and the impact of nonadherence in specific diseases. Adherence in Dermatology bridges the gap between outcomes researchers and clinicians by explaining the latest findings in plain language, with examples from everyday dermatologic practice.

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Part I
What Is Known About Adherence Behavior
Springer International Publishing Switzerland 2016
Scott A. Davis (ed.) Adherence in Dermatology 10.1007/978-3-319-30994-1_1
1. Impact of Nonadherence in Dermatology
Nazmine Sohi 1 and Scott A. Davis 1, 2
(1)
Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
(2)
Division of Pharmaceutical Outcomes and Policy, University of North Carolina Eshelman School of Pharmacy, Chapel Hill, NC, USA
Scott A. Davis
Email:
Nonadherence is ubiquitous in the field of dermatology. The importance of it is demonstrated with how impactful it is in the practice setting. For example, the effectiveness of scientifically proven treatment protocols and the presence of certain side effects are contingent upon adherence [].
1.1 Clinical Impact
In order to provide the best clinical care possible, healthcare providers need to be aware of patient adherence. Tracking adherence allows us to accurately assume whether or not a treatment was effective. Physicians should understand the difference between treatment outcomes in clinical trials in comparison to the outcomes in practice [].
More seriously, not adhering to physicians instructions unnecessarily puts patients at greater risks. For example, it was reported that only about 30% of adults properly engage in skin-protective practices []. This disappointment is not inevitable; as we shall see in this book, there is much that can be done. However, first it is necessary to realize that the patient is disappointed in some way with the regimen and would welcome changes that would make the treatment more satisfactory.
1.2 Economic Impact
When considering the healthcare system at large, nonadherence is linked to higher associated costs []. Although similar data are not yet available in dermatology, it would not be surprising that the costs of dermatological treatments and drugs might also be higher with higher nonadherence rates. Future research needs to address this gap in the literature.
1.3 Magnitude
Lack of adherence is relevant to discuss in dermatology because it is evidently widespread [).
Healthcare professionals are in a position to confront and correct the gaps in care that nonadherence creates. Knowledge on how to educate and support patients correctly has the potential to change these disappointing statistics []. There is not yet a guide available that addresses adherence in dermatology. This book will provide you with the right tools and resources to become aware of an overlooked, yet critical issue in practice.
References
Anderson KL, Dothard EH, Huang KE, Feldman SR (2015) Frequency of primary nonadherence to acne treatment. JAMA Dermatol 151(6):623626 CrossRef PubMed
Peris K, Neri L, Fargnoli MC, Pellacani G (2014) Physicians concerns towards prescription adherence and treatment effectiveness in the clinical management of actinic keratosis. G Ital Dermatol Venereol 149(2):193198 PubMed
Vangeli E, Bakhshi S, Baker A et al (2015) A systematic review of factors associated with non-adherence to treatment for immune-mediated inflammatory diseases. Adv Ther 32(11):9831028 CrossRef PubMed PubMedCentral
Davis SA, Feldman SR (2013) Using Hawthorne effects to improve adherence in clinical practice: lessons from clinical trials. JAMA Dermatol 149(4):490491 CrossRef PubMed
Nolan BV, Feldman SR (2009) Adherence, the fourth dimension in the geometry of dermatological treatment. Arch Dermatol 145(11):13191321 CrossRef PubMed
Buller DB, Cokkinides V, Hall HI et al (2011) Prevalence of sunburn, sun protection, and indoor tanning behaviors among Americans: review from national surveys and case studies of 3 states. J Am Acad Dermatol 65(5 Suppl 1):S114S123 PubMed
Evers AW, Kleinpenning MM, Smits T et al (2010) Treatment nonadherence and long-term effects of narrowband UV-B therapy in patients with psoriasis. Arch Dermatol 146(2):198199 CrossRef PubMed
Thorneloe RJ, Bundy C, Griffiths CE, Ashcroft DM, Cordingley L (2013) Adherence to medication in patients with psoriasis: a systematic literature review. Br J Dermatol 168(1):2031 CrossRef PubMed
Armstrong AW, Robertson AD, Wu J, Schupp C, Lebwohl MG (2013) Undertreatment, treatment trends, and treatment dissatisfaction among patients with psoriasis and psoriatic arthritis in the United States: findings from the National Psoriasis Foundation surveys, 20032011. JAMA Dermatol 149(10):11801185 CrossRef PubMed
Osterberg L, Blaschke T (2005) Adherence to medication. N Engl J Med 353:487497 CrossRef PubMed
Kane SV, Chao J, Mulani PM (2009) Adherence to infliximab maintenance therapy and health care utilization and costs by Crohns disease patients. Adv Ther 26(10):936946 CrossRef PubMed
Logan T The future of community pharmacy: star ratings, medication adherence, and community pharmacys evolving role. Available at http://www.asapnet.org/files/January2014/Presentations/ASAPJan14_Presentations08_Logan1.pdf . Accessed 26 Dec 2015
Sokol MC, McGuigan KA, Verbrugge RR, Epstein RS (2005) Impact of medication adherence on hospitalization risk and healthcare cost. Med Care 43:521530 CrossRef PubMed
Richards HL, Fortune DG, Griffiths CE (2006) Adherence to treatment in patients with psoriasis. J Eur Acad Dermatol Venereol 20(4):370379 CrossRef PubMed
Snyder S, Crandell I, Davis SA, Feldman SR (2014) Medical adherence to acne therapy: a systematic review. Am J Clin Dermatol 15(2):8794 CrossRef PubMed
Springer International Publishing Switzerland 2016
Scott A. Davis (ed.) Adherence in Dermatology 10.1007/978-3-319-30994-1_2
2. Models of Adherence
Imran Aslam 1, Michael E. Farhangian 1 and Steven R. Feldman 1
(1)
Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
Steven R. Feldman
Email:
Whether patients take their medication is determined by a myriad of factors ranging from socioeconomic factors to disease-related issues []. While many of these factors are immutable by the dermatologist, having a solid understanding of what internally drives patients to engage in health-seeking behavior can be instrumental in tackling adherence problems. Adherence models are theoretical constructs that have been created to help further elucidate the complexities of what drives patients to adhere to their medications. These models provide a framework for which interventions can be developed to target the major determining factors that can adversely affect adherence to medication.
There are many models of adherence that have been developed. These models of adherence have been categorized into (1) biomedical, (2) behavioral, (3) communication, (4) cognitive, and (5) self-regulatory in addition to the more recent transtheoretical model (Table ].
Table 2.1
Models of adherence
Models of adherence
Overview
Pros
Cons
Biomedical
Emphasizes that patients are passive recipients of treatment
Leads to advances in adherence research []
Ignores basic social and psychological factors that influence adherence []
Behavioral
Past experiences dictate adherence behaviors
Using rewards can help implement positive lifestyle changes and improve adherence to medication []
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