Characterization of socioeconomic status of Japanese patients with atopic dermatitis showing poor medical adherence and reasons for drug discontinuation

Hiroyuki Murota; Satoshi Takeuchi; Makoto Sugaya; Miki Tanioka; Daisuke Onozuka; Akihito Hagihara; Hidehisa Saeki; Shinichi Imafuku; Masatoshi Abe; Yoichi Shintani; Sakae Kaneko; Koji Masuda; Takaaki Hiragun; Naoko Inomata; Yuki Kitami; Yuichiro Tsunemi; Shinya Abe; Miwa Kobayashi; Donald E Morisky; Masutaka Furue; Norihito Katoh

doi:10.1016/j.jdermsci.2015.05.010

Characterization of socioeconomic status of Japanese patients with atopic dermatitis showing poor medical adherence and reasons for drug discontinuation

J Dermatol Sci. 2015 Sep;79(3):279-87. doi: 10.1016/j.jdermsci.2015.05.010. Epub 2015 Jun 16.

Authors

Hiroyuki Murota¹, Satoshi Takeuchi², Makoto Sugaya³, Miki Tanioka⁴, Daisuke Onozuka⁵, Akihito Hagihara⁵, Hidehisa Saeki⁶, Shinichi Imafuku⁷, Masatoshi Abe⁸, Yoichi Shintani⁹, Sakae Kaneko¹⁰, Koji Masuda¹¹, Takaaki Hiragun¹², Naoko Inomata¹³, Yuki Kitami¹⁴, Yuichiro Tsunemi¹⁵, Shinya Abe¹⁶, Miwa Kobayashi¹⁷, Donald E Morisky¹⁸, Masutaka Furue¹⁹, Norihito Katoh¹¹

Affiliations

¹ Department of Dermatology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan. Electronic address: h-murota@derma.med.osaka-u.ac.jp.
² Department of Dermatology, Federation of National Public Service Personnel Mutual Aid Associations, Hamanomachi Hospital, 3-3-1 Nagahama, Chuo-ku, Fukuoka 810-8539, Japan.
³ Department of Dermatology, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8654, Japan.
⁴ Tanioka Dermatology Clinic, Higashihama-Minami-cho 662, Fushimi-ku, Kyoto 612-8213, Japan.
⁵ Department of Health Care Administration and Management, Kyushu University Graduate School of Medical Sciences, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan.
⁶ Department of Dermatology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8602, Japan.
⁷ Department of Dermatology, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
⁸ Kojinkai Sapporo Skin Clinic, 1-1 Minami 3, Nishi 2, Chuo-ku, Sapporo, Hokkaido 060-0063, Japan.
⁹ Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan.
¹⁰ Department of Dermatology, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane 693-8501, Japan.
¹¹ Department of Dermatology, Kyoto Prefectural University of Medicine Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan.
¹² Department of Dermatology, Integrated Health Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
¹³ Department of Environmental Immuno-Dermatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan.
¹⁴ Department of Dermatology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan.
¹⁵ Department of Dermatology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan.
¹⁶ Department of Dermatology, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa 920-0293, Japan.
¹⁷ Department of Dermatology, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi-ku, Kitakyushu, Fukuoka 807-8555, Japan.
¹⁸ Department of Community Health Sciences, UCLA Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA, USA.
¹⁹ Department of Dermatology, Kyushu University Graduate School of Medical Sciences, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan.

PMID: 26255207
DOI: 10.1016/j.jdermsci.2015.05.010

Abstract

Background: Patients' high adherence to medication is indispensable for the management of skin diseases including atopic dermatitis. We previously showed poor medication adherence in Japanese dermatological patients.

Objective: This study was conducted to determine the level of adherence to oral or topical medication in Japanese patients with atopic dermatitis, attempting to characterize the socioeconomic status of those patients with poor adherence.

Methods: A web questionnaire survey on demographic data as well as adherence level was conducted on patients registered in the monitoring system. Adherence level was assessed with Morisky Medication Adherence Scale-8 (MMAS-8). Among a total of 3096 respondents with dermatological disorders, data of 1327 subjects with atopic dermatitis were extracted and analyzed.

Results: More than 80% of subjects felt that both oral and topical medications were safe and efficacious, while less than 60% of them were satisfied with their treatment. Levels of adherence to oral and topical treatments were evaluated with MMAS-8, giving scores of 4.6 and 4.2, respectively. Demographic factors such as gender, marital status, state of employment, alcohol consumption, frequency of hospital visits, and experience of drug effectiveness had a significant impact on the degree of adherence to treatment.

Conclusion: Medication adherence level in Japanese subjects with atopic dermatitis was relatively low compared with that of other chronic diseases. Our survey has characterized patients with poor adherence, who are good targets for interventions to maximize potentially limited healthcare resources.

Keywords: Adherence; Atopic dermatitis; Morisky Medication Adherence Scale-8 (MMAS-8); Treatment satisfaction.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Administration, Cutaneous
Administration, Oral
Adolescent
Adult
Aged
Aged, 80 and over
Alcohol Drinking
Dermatitis, Atopic / drug therapy*
Dermatologic Agents / administration & dosage
Employment
Female
Humans
Japan
Male
Marital Status
Medication Adherence / psychology*
Medication Adherence / statistics & numerical data*
Middle Aged
Patient Satisfaction
Sex Factors
Surveys and Questionnaires
Treatment Outcome
Young Adult

Substances

Dermatologic Agents