results 1 exp COMPLIANCE/ 2 exp Treatment Compliance/ 3 exp PERSISTENCE/ 3382 4 exp Treatment Refusal/ 730 5 exp Drug Withdrawal/ 7615 6 exp Client Attitudes/ 7 exp Treatment Dropouts/ 2371 8 exp Health Behavior/ 9

Background Poor adherence to topical antipsoriatic drugs limits treatment effectiveness. Objective The aim of this study was to investigate how healthcare providers may improve psoriasis patients' adherence to topical treatment. Materials and methods A systematic literature search was performed for English-language articles in Embase, Medline, PsycINFO, Cinahl, Scopus, and the Cochrane Library. Results Ten studies of varying quality were identified. Two randomized controlled trials (RCTs) testing the adherence-improving potential of interventions by healthcare providers to support patients showed improvement in adherence to topical treatment. In a prospective study with a pre/post design, an individualized, face-to-face consultation reported an improvement in patient-reported adherence to topical treatment over a 9-week period. Based on seven qualitative studies obtaining insights from either patients or healthcare providers, healthcare providers may need to address socioeconomic factors, healthcare system factors, and treatment-, patient-and disease-related factors in interventions that aim to improve the adherence of psoriasis patients to topical antipsoriatic drugs. A c c e p t e d M a n u s c r i p t Conclusion There is a need to develop better adherence-improving interventions. A good patienthealthcare provider relationship is considered crucial to adherence and may be an important intervention target. Before interventions to improve adherence to topicals can be recommended for the clinic, the intervention should be tested in high-quality RCTs.

No abstract