Adherence to acitretin and home narrowband ultraviolet B phototherapy in patients with psoriasis

Adherence in the Treatment of Psoriasis: A Systematic Review

“…Moreover, the efficacy of topical medication is often inferior to that of the systemic agents, and even with effective topical therapy only 40% of patients would respond ‘very well’, while 40% would experience partial improvement and 20% would not respond at all to the treatment [58]. Consistent with this is the finding that the generally inadequate adherence in the treatment of psoriasis is even worse under topical therapy [44] and many patients do not even redeem their prescriptions for topical preparations [46]. The dissatisfaction was also highlighted in an anonymous questionnaire survey of 52 patients: 40% of the participants were non-adherent and applied the topical cortisone preparation either less or more frequently than prescribed [38].…”

“…Tablet ingestion was determined with a MEMS cap, irradiation with data loggers for the UV lamps. Over the 12-week observation period, acitretin ingestion decreased continuously from around 94 to 54%, while adherence to phototherapy remained constant [44]. A survey performed in 2006 also showed that adherence is greater under therapy with biologicals than under other psoriasis treatments [45].…”

“…The frequency of use of the phototherapy remained almost constant over the 12-week observation period – an indication that the necessary expenditure of time did not negatively affect adherence [44]. Biologicals, which have now been available in psoriasis therapy for several years, display better efficacy than the previously available options [49].…”

A guide to prescribing home phototherapy for patients with psoriasis: The appropriate patient, the type of unit, the treatment regimen, and the potential obstacles

“…9 Short-term adherence with the prescribed treatment regimens in home phototherapy is surprisingly good. 29 To avoid potential side effects and poor adherence, the patient should be competent to operate the light unit and follow instructions. In addition, some clinicians may opt to prescribe a unit with safety features that limit exposures, units that track treatments and make it available to the provider (Table II), or require patients sign a contract and/or keep a phototherapy log.…”

A review of targeted ultraviolet B phototherapy for psoriasis

“…27 One recent study of 27 subjects reported good adherence and high patient satisfaction to home phototherapy over 12 weeks. 29 Although limited efficacy studies exist for handheld home UVB use, these findings suggest handheld home UVB phototherapy as a costeffective choice for long-term management of localized psoriasis.…”