Adherence of patients to acne therapy using systemic isotretinoin

Background. Adherence to treatment of patients with acne may be an important factor influencing the efficacy of treatment using a drug from the systemic retinoids group. Objective. Determination of adherence to therapy with isotretinoin in patients with severe acne and its effect on treatment results. Material and methods. A survey of 58 patients with severe acne (mean age 21.25±2.08 years) was performed. Patients, who refused treatment with systemic isotretinoin, formed group I (n=17) — initial absence of adherence to treatment. Testing in group I was performed immediately after receiving the refusal of systemic therapy. Other patients (n=41) agreed to receive therapy with systemic isotretinoin — group II, and their compliance level was tested after completion of the treatment course. This study included individual questionnaires and the Morisky-Green compliance determination test, on the basis of the results of which patients of group II were divided into 2 subgroups: IIa (low adherence to treatment) and IIb (high adherence to treatment). Results. The primary causes for the absence of adherence to treatment with isotretinoin were the risk of developing adverse events, as well as the belief that acne is prone to spontaneous resolution or that the disease is related to gastrointestinal pathology or immune disorders. The low adherence of patients to treatment during the therapy with systemic isotretinoin contributed to a more frequent development of adverse events and relapse of dermatosis, predominantly in male patients with short duration of acne course. Conclusion. The low adherence of patients to therapy is a major challenge in modern medicine. The results of this study demonstrate the need to carry out various activities or create conditions for improving patients’ compliance during acne therapy using systemic isotretinoin.