Framing atopic dermatitis topical medication application site discomfort as a signal of efficacy improves willingness to continue use

Bashyam, Arjun M.; Cuéllar-Barboza, Adrián; Masicampo, E. J.; Feldman, Steven R.

doi:10.1016/j.jaad.2020.03.074

Cited by 8 publications

(11 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…patients were randomly assigned to three hypothetical scenarios in which they were given a topical medication and experienced one of three side effects [28]. They experienced either a painful sensation, a non-painful sensation, or no sensation.…”

Section: Advanced Adherence Interventionsmentioning

confidence: 99%

“…Each group reported on a 9-point Likert-type scale how willing they would be to continue the use of the medication. Their willingness to continue to use the medication increased when they were educated by their physician about the possible side effect (p < 0.001; d = 0.46) [28]. Their willingness was even greater when the unpleasant sensation was framed as an indicator of efficacy (p < 0.001, d = 1.32) [28].…”

Section: Advanced Adherence Interventionsmentioning

confidence: 99%

“…Their willingness to continue to use the medication increased when they were educated by their physician about the possible side effect (p < 0.001; d = 0.46) [28]. Their willingness was even greater when the unpleasant sensation was framed as an indicator of efficacy (p < 0.001, d = 1.32) [28]. The hurdle of side effects can be made an advantage through framing [28].…”

Section: Advanced Adherence Interventionsmentioning

confidence: 99%

“…Their willingness was even greater when the unpleasant sensation was framed as an indicator of efficacy (p < 0.001, d = 1.32) [28]. The hurdle of side effects can be made an advantage through framing [28].…”

Section: Advanced Adherence Interventionsmentioning

confidence: 99%

“…After both time points, risankizumab-rzaa, brodalumab, ixekizumab and guselkumab had the highest PASI 90 scores [29]. Educating patients on side effects before starting new treatments increases adherence, and framing negative side effects as indicators for positive outcomes and evidence of treatment efficacy further increases this effect [28]. In a recent survey study, 1039 AD patients were randomly assigned to three hypothetical scenarios in which they were given a topical medication and experienced one of three side effects [28].…”

Section: When Stronger Drugs Are Neededmentioning

confidence: 99%

See 4 more Smart Citations

Refractory Pediatric Psoriasis and Atopic Dermatitis: The Importance of Therapeutical Adherence and Biological Management

et al. 2021

Self Cite

View full text Add to dashboard Cite

The rates of refractory pediatric psoriasis and atopic dermatitis (AD) have steadily risen over the last few decades, demanding newer and more effective therapies. This review aims to explore the reasons for resistant disease, as well as its management; this includes the indications for, efficacy of, and safety of current therapies for refractory pediatric dermatologic disease. A PubMed search for key phrases was performed. Poor medication adherence is the most common cause of resistant disease and may be managed with techniques such as simplified treatment regimens, more follow-ups and educational workshops, as well as framing and tailoring. Once problems with adherence are ruled out, escalating treatment to stronger biologic therapy may be indicated. Development of anti-drug antibodies (ADAs) can cause patients’ disease to be refractory in the presence of potent biologics, which may be addressed with regular medication use or concomitant methotrexate. If patients with AD fail to respond to biologic therapy, a biopsy to rule out mycosis fungoides, or patch testing to rule out allergic contact dermatitis, may be indicated. A limitation of this study is the absence of more techniques for the management of poor medication adherence. Managing medication adherence, escalating treatment when appropriate, and addressing possible anti-drug antibodies will help assure control and relief for patients with resistant disease.

show abstract

Section: Advanced Adherence Interventionsmentioning

confidence: 99%

Section: Advanced Adherence Interventionsmentioning

confidence: 99%

Section: Advanced Adherence Interventionsmentioning

confidence: 99%

Section: Advanced Adherence Interventionsmentioning

confidence: 99%

Section: When Stronger Drugs Are Neededmentioning

confidence: 99%

See 3 more Smart Citations

Refractory Pediatric Psoriasis and Atopic Dermatitis: The Importance of Therapeutical Adherence and Biological Management

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

A narrative review of systematic reviews on adherence to psoriasis treatments

Feldman

Rakita

Porter

et al. 2021

Dermatological Reviews

Self Cite

View full text Add to dashboard Cite

Introduction: Psoriasis is a prevalent disorder of the skin which presents with scaly, red plaques and leads to significant morbidity and mortality. Thus, successful treatment is of great importance to the patient and provider. Objective: Nonetheless, a significant cause of treatment failure may not be incorrect diagnosis or treatment, but rather nonadherence. We aimed to elucidate what factors influence adherence to psoriasis treatments. Methods: We conducted a review on the literature on adherence by adapting search terms derived from an existing systematic review (SR) on psoriasis adherence. Only data relevant to patients with psoriasis were extracted, including the type of medications they were using, when available. All of the factors associated with adherence were grouped by medication type and whether they had positive, negative, or no association with adherence, or mixed evidence. Results: We found a unifying theme across SR was the wide heterogeneity in methodology of primary studies. There are pearls to be gleaned from this review, such as the power of a well‐written prescription, shared decision‐making, using effective treatments, having frequent follow‐up, and reframing adverse effects to improve adherence. Conclusion: There is widespread prevalence of both mixed and contradicting conclusions across the SR, which may stem from the fact that studies on adherence vary extensively in their definition of adherence, their method for evaluating it, and their patient populations.

show abstract

Tackling steroid phobia: Insights from behavioural economics and psychological approaches

Nakashima,

Ohtake,

Otsuka

2023

JEADV Clinical Practice

View full text Add to dashboard Cite

Steroid phobia, characterized by an irrational fear or avoidance of topical corticosteroids, poses a significant challenge to the effective treatment of various skin conditions, including atopic dermatitis (AD) and psoriasis. This issue has its roots in the introduction of topical corticosteroids in the 1950s and has been perpetuated by concerns regarding adverse effects and misinformation. International Dermatological Societies including the Japanese Dermatological Association have endeavored to address this problem by providing information and guidance to physicians and patients, resulting in a better understanding of appropriate steroid use and risk management. Despite these efforts, steroid phobia has not been fully resolved in the world, including in Japan. To shed light on potential solutions, this review explores the field of behavioral economics, which offers insights into human decision-making processes and cognitive biases. Richard Thaler's concept of nudges emerges as a promising strategy for influencing patients' decision-making regarding steroid treatments. However, the effectiveness of nudges may vary depending on the strength of an individual's concerns and fears. In cases where patients exhibit strong resistance to steroid use, alternative psychological techniques that establish trust and facilitate clear communication may be more beneficial. This review emphasizes the necessity of adopting a multifaceted approach that integrates principles from behavioral economics and employs complementary psychological strategies to address steroid phobia and enhance treatment adherence in affected patient populations. By combining these approaches, healthcare professionals can tackle the complex nature of steroid phobia and promote better treatment outcomes for patients with skin conditions.

show abstract

Framing atopic dermatitis topical medication application site discomfort as a signal of efficacy improves willingness to continue use

Cited by 8 publications

References 7 publications

Refractory Pediatric Psoriasis and Atopic Dermatitis: The Importance of Therapeutical Adherence and Biological Management

Refractory Pediatric Psoriasis and Atopic Dermatitis: The Importance of Therapeutical Adherence and Biological Management

A narrative review of systematic reviews on adherence to psoriasis treatments

Tackling steroid phobia: Insights from behavioural economics and psychological approaches

Contact Info

Product

Resources

About