Dermatologic Medication Class, Administration Contributes to Nonadherence

A woman taking medication from a prescription bottle
A woman taking medication from a prescription bottle
Primary nonadherence is a documented problem in many specialties, including dermatology.

Medication class and route of administration within certain drug categories are key factors linked to patients’ primary nonadherence to dermatologic medications, according to results of a study published in the Journal of Dermatological Treatment.

The medical records of new dermatology patients from a single urban-net hospital outpatient dermatology clinic with a closed pharmacy system were examined between January 1, 2011, and December 31, 2013. A total of 2490 patients participated in the study, with 4307 prescriptions assigned to them.

Overall, 75.3% of prescriptions were filled within the index year. The investigators noted that more electronic prescriptions were filled than those prescribed on paper (risk ratio [RR], 1.2; 95% CI, 1.16-1.26), and patients aged 59 to 69 years were significantly more likely to fill the prescription than patients younger than 30 years (RR, 1.17; 95% CI, 1.17-1.28).

When ranked in order of frequency, the most commonly prescribed dermatologic medications were topical corticosteroids, topical antibiotics, topical retinoids, oral antibiotics, and topical antifungal agents. The overall rate of primary nonadherence to dermatologic medications was 24.7%. Compared with topical corticosteroids, topical antibiotics (RR, 0.9; 95% CI, 0.84-0.95), oral antifungal agents (RR, 0.69; 95% CI, 0.59-0.81), and oral antiviral agents (RR 0.65; 95% CI, 0.46-0.93) were less likely to be filled. In contrast, topical vitamin D analogs (RR, 1.15; 95% CI, 1.02-1.28), oral immunomodulators (RR, 1.11; 95% CI, 1.04-1.19), and oral retinoids (RR, 1.15; 95% CI, 1.04-1.27) were more likely to be filled.

Because increased risk for nonadherence may be associated with medication class and route of administration, identification of key factors is important when considering ways in which to reduce medication nonadherence in dermatology patients.

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Rutherford A, Glass DA, Suarez EA, Adamson AS. Prescription-level factors associated with primary nonadherence to dermatologic medications [published online August 18, 2017]. J Dermatolog Treat. doi: 10.1080/09546634.2017.1365115