Barriers and facilitators of adherence to treatment among women with vulvovaginal candidiasis: a qualitative study

Abstract

Background Non-adherence of patients with vulvovaginal candidiasis (VVC) to treatment recommendations leads to treatment failure and recurrence of infection. Therefore, this qualitative study was conducted to identify barriers and facilitators of observance of treatment among women afflicted with vulvovaginal candidiasis. Methods This qualitative study was conducted through 26 in-depth unstructured interviews with 24 patients and 2 gynecologists using purposeful sampling with maximum variation in Ahvaz, southwest Iran. Interviews were conducted in person at health centers and the gynecologist’s offices. MAXQDA 10 software and conventional content analysis were used for data analysis. Results The findings showed barriers and facilitator factors of adherence to treatment in women with VVC. Some of these factors lead to an increase in adherence to treatment, and others play the role of hindering factors. These factors were classified into two main categories: patients’ beliefs and patients’ fears and concerns. Conclusion The results of this study showed that many of the behaviors of patients from the acceptance of the diagnosis process to treatment are rooted in the patient's beliefs and fears. Therefore, it seems necessary to design and carry out interventions based on the findings of this study, which can be used in the development of appropriate solutions, treatment guidelines, and adopting a policy for treatment adherence.

Anti-Biofilm Activity of Phenyllactic Acid against Clinical Isolates of Fluconazole-Resistant Candida albicans

“…The majorities of VVC are caused by the abnormal growth of Candida spp., normally present in the vaginal flora, with the transition of the fungus from ovoid yeast-like cells to elongated hyphae and the formation of biofilm. Candida albicans , which is part of normal vaginal microflora and becomes a robust opportunistic fungal pathogen under various conditions, has been considered the major causes of vulvovaginitis, the medical impact of which also depending on the strain ability to form biofilms [ 4 ]. Regarding treatment, intravaginal and oral azole drugs are currently prescribed for the treatment of VVC and Fluconazole, which is the drug of choice led to the acquisition of inherent resistance, in about 30% of vaginal positive cultures, consequently resulting in failure of therapeutic treatment of the infection [ 5 , 6 ].…”

Candidíase Vulvovaginal: Cuidado Farmacêutico Na Dispensação De Antifúngicos Na Farmácia Comunitária

“…Segundo dados da literatura, a CVV é considerada recorrente quando a mulher manifesta pelo menos três a quatro episódios a cada 12 meses (CIANCI et al, 2020). Vários fatores têm sido associados a CVVR, como estado imunocomprometido, diabetes mellitus, genética, frequência de atividade sexual, hábitos de higiene, disbiose do microbioma vaginal, e ainda origens idiopáticas (ERFANINEJAD et al, 2022). Ainda, devido a resistência a medicamentos ou a subdosagens (NYIRJESY et al, 2022).…”