Take your medicine

A new study¹ suggests that 27% of acne patients don’t get all or even, perhaps, any of their doctor-recommended acne medications. These patients are more likely to get their medications when only one treatment is prescribed.

“We know that acne has multiple pathogenic factors, and we often prescribe multiple drugs to address them in order to get the best outcomes.  But at the same time, prescribing multiple drugs as part of complex treatment regimens may result in poor adherence to treatment.  Patients tend to drop off complex regimens more quickly, and, in this study, we found they are often do not even fill the prescriptions when multiple different products are recommended,” the study’s lead author Steven R. Feldman, M.D., Ph.D., professor of dermatology at Wake Forest Baptist, said to Dermatology Times.

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Wake Forest Baptist Medical Center researchers surveyed 143 acne patients from an outpatient dermatology clinic. The patients had been prescribed one or more acne treatments.

They found:

• Of patients who were prescribed just one acne medication, 9% failed to get their doctor-recommended treatment. 
• Patients who were prescribed two medications had the highest rate of primary non-adherence at 40%.
• Thirty-one percent of patients who were prescribed three or more medications didn’t get all their medications.

Other study results, which were not statistically significant, include: prescriptions for topical medications were less likely to be filled than those for oral medications; over-the-counter products were less likely to be obtained than prescription drugs; and paper prescriptions were less likely to be filled than electronic ones.

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Among the take-home points for dermatologists, according to Dr. Feldman, is to be on the lookout for poor adherence as a cause of poor treatment outcomes.

The news presents a challenge for dermatologists and their acne patients because multiple agents are typically required to address the multiple factors that cause acne. One solution could be to simplify treatment regimens by prescribing products that contain two or more active ingredients in order to reduce nonadherence, he said.

“The development of combination products can address this hurdle to adherence.  For many years we've had combination antibiotic-benzoyl peroxide products.  The availability of a retinoid-benzoyl peroxide product lets us simplify the regimen, while including the key treatment elements recommended in treatment guidelines,” Dr. Feldman said.

Another thing to keep in mind is that the issue of noncompliance might not be limited to acne patients.  

“Poor adherence to treatment is exceptionally common with topical treatment across a wide array of disease from acne, to atopic dermatitis to psoriasis,” he said.   

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NEXT: References

References:

1.     Anderson KL, Dothard EH, Huang KE, Feldman SR. Frequency of Primary Nonadherence to Acne Treatment. JAMA Dermatol. 2015