EVALUATION OF ADHERENCE TO MEDICATION IN PATIENTS OF PSORIASIS: TOPICAL VERSUS SYSTEMIC THERAPY

*Dr. Smita Sontakke, Dr. Mitali Wagh, Dr. Nikita Ingale, Dr. Jayesh Mukhi, Dr. Vijay Motghare and Dr. Mrunalini Kalikar

ABSTRACT

Aim: To evaluate adherence to medication and to compare adherence to topical and systemic therapy in patients of psoriasis. Methods: This was a prospective, cross-sectional, questionnaire-based study carried out in patients of psoriasis on treatment for at least three months. Study subjects were interviewed by direct face-to-face interview and information entered in semi-structured, open-ended questionnaire. Adherence was also assessed by Morisky 4-item medication adherence scale. The same patient was evaluated separately for adherence to topical and systemic medication. Results: Significantly more number of patients followed medication schedule for systemic medicines(70.3%) compared to topical(50.5%) (p=0.03) In both groups, most common type of non-adherence was: not buying all medicines. Number of patients who thought that not taking systemic medicines would adversely affect the disease was significantly more than those who thought the same about topical medicines(p=0.007). Most common reasons for not following medication schedule were: high cost of medicines, forgetfulness, and complex dosing schedule. Antihistaminics were the most preferred systemic medication and Calcipotriol 0.005% and clobetasol 0.05% combination was the most preferred topical medication. Conclusion: Rate of high adherence was significantly more with systemic medications compared to topical in the same patients. Majority of patients believed that not using the systemic medicines would more adversely affect the disease and hence they were more adherent to systemic therapy compared to topical. Hence, when prescribing topical treatments, it is important to emphasize upon the patients the importance of being adherent to medication as this is important for effective and long term control of psoriasis.

Keywords: MMAS-4, Morisky 4-item medication adherence scale, cross-sectional study.