International Journal of Clinical Dermatology

Research Article | | Peer-Reviewed |

Treatment Adherence Among Malagasy Patients with Atopic Dermatitis Seen at the Department of Dermatology, Antananarivo, Madagascar

Received: 16 February 2024    Accepted: 1 March 2024    Published: 13 March 2024
Views:       Downloads:

Share This Article

Abstract

Atopic dermatitis (AD) is a chronic inflammatory skin disorder characterized by intense pruritic eczematous lesions. Poor adherence to treatment is a major factor limiting treatment outcomes in patients with AD. This study aimed to assess treatment adherence in Malagasy patients with AD. It was conducted over one year in children and adult patients with AD seen at the Department of Dermatology University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar. Morisky Medication Adherence Scale-8 (MMAS-8) was used to assess patients’ treatment adherence. We included 44 children and 21 adults. The mean age was 4.29 ± 4.13 years and 35.28 ± 16.88 years, respectively. All of our patients receive topical treatment and no specific oral treatment such as biotherapy or immunosuppressant. A low adherence rate was observed in 61.90% of adult patients and the mean MMAS-8 score was 2.56 ± 1.6. In children, the mean MMAS¬8 score was 5.9 ± 1.53 and poor adherence was seen in 45.45%. The adherence level was significantly associated with age, educational status, and marital status (p < 0.05). Low treatment adherence is preponderant among Malagasy patients with AD. We did not find significant correlations between adherence levels and monthly income, frequency of follow-up, severity of AD, or insurance coverage.

DOI 10.11648/j.ijcd.20240701.14
Published in International Journal of Clinical Dermatology (Volume 7, Issue 1, June 2024)
Page(s) 16-23
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Age, Atopic Dermatitis, Educational Status, Low Adherence, Malagasy, Married

References
[1] Langan SM, Irvine AD, Weidinger S. Atopic dermatitis. Lancet. 2020; 396: 345-60.
[2] Weidinger S, Novak N. Atopic dermatitis. Lancet. 2016; 387(10023): 1109-1122.
[3] Feldman SR, Cox LS, Strowd LC, Gerber RA, Faulkner S, Sierka D et al. The Challenge of Managing Atopic Dermatitis in the United States. Am Health Drug Benefits. 2019; 12(2): 83-93.
[4] Schmid-Grendelmeier P, Takaoka R, Ahogo KC, Belachew WA, Brown SJ, Rapelanoro Rabenja F, et al. Position Statement on Atopic Dermatitis in Sub-Saharan Africa: current status and roadmap. J Eur Acad Dermatol Venereol. 2019; 33: 2019-28.
[5] Schmid-Grendelmeier P, Rapelanoro Rabenja F, Beshah AM, Ball MD, Dlova N, Faye O et al. J Eur Acad Dermatol Venereol. 2023 Apr 5. https://doi.org/10.1111/jdv.19096
[6] Sendrasoa FA, Ranaivo IM, Razanakoto NH, Andrianarison M, Raharolahy O, Ratovonjanahary VT, et al. Epidemiology and associated factors of atopic dermatitis in Malagasy children. Allergy Asthma Clin Immunol. 2020; 16: 4.
[7] Sendrasoa FA, Ramily SL, Razafimaharo TI, Ranaivo IM, Andrianarison M, Raharolahy O, et al. Atopic dermatitis in adults: A cross-sectional study in the department of dermatology, Antananarivo, Madagascar. JAAD Int. 2021; 4: 28-31.
[8] Sabate E. Adherence to long-term therapies: evidence for action. Geneva: World Health Organization, 2003. [Consulté le 07 Janvier 2022]. Consultable à l’URL: http://whqlibdoc.who.int/publications/2003/9241545992.pdf
[9] Ahn CS, Culp L, Huang WW, Davis SA, Feldman SR. Adherence in dermatology, Journal of Dermatological Treatment; https://doi.org/10.1080/09546634.2016.1181256
[10] Hodari KT, Nanton JR, Carrol CL, Feldamn SR, Blakrishnan. Adherence in dermatology: A review of the last 20 years. 2006; https://doi.org/10.1080/09546630600688515
[11] Nolan BV, Feldman SR. Dermatologic Medication Adherence. Dermatol Clin. 2009; 113–120.
[12] Ranaivo IM, Sendrasoa FA, Raharolahy O, Andrianarison M, Ramarozatovo LS, Rapelanoro Rabenja F et al. Observance thérapeutique au cours des dermatoses chroniques à l’hôpital universitaire de Befelatanana. International Journal of Progressive Sciences and Technologies (IJPSAT). 2019; 17: 104-10.
[13] Williams HC, Jburney PG, Strachan D, Hay RJ. The U.K. Working Party’s Diagnostic Criteria for Atopic Dermatitis II. Br J Dermatol. 1994; 1313: 397-405.
[14] Morisky DE, Ang A, Krousel-Wood M, Ward HJ. Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens (Greenwich) 2008; 10: 348–354.
[15] Bland JM, Altman DG. Cronbach’s alpha. BMJ. 1997; 314(7080): 572. https://doi.org/10.1136/bmj.314.7080.572
[16] Kaneko S, Masuda K, Hiragun T, Inomata N, Furue M, Onozuka D. Transient improvement of urticaria induces poor adherence as assessed by Morisky Medication Aherence Scale-8. Journal of Dermatology. 2015; 1078- 82.
[17] DiLucca-Chrisment J, Gilliet M. Traitements systémiques émergents de la dermatite atopique. Rev Med Suisse. 2018: 685-9.
[18] Mazaud C, Staumont D, Beauchet A, Catteau B, Lasek A, Puzenat E, et al. Dupilumab dans la dermatite atopique modérée à sévère de l’enfant. Ann Dermatol Venereol. 2019; 146: 107-8.
[19] Krejci-Manwaring J, Tusa MG, Carroll C, Camacho F, Kaur M, Carr D, et al., Stealth monitoring of adherence to topical medication: adherence is very poor in children with atopic dermatitis, J. Am. Acad. Dermatol. 2007; (56) 211–6.
[20] S. R. Feldman, F. T. Camacho, J. Krejci-Manwaring, C. L. Carroll, R. Balkrishnan, Adherence to topical therapy increases around the time of office visits, J. Am. Acad. Dermatol. 57(2007) 81–83.
[21] Torrelo A, Ortiz J, AlomarA, Ros S, Pedrosa E, Cuervo J. Health-related quality of life, patient satisfaction, and adherence to treatment in patients with moderate or severe atopic dermatitis on maintenance therapy: the CONDA-SAT study. Actas Dermosifiliogr 2013; 104: 409–417.
[22] Furue M, Onozuka D, Takeuchi S et al. Poor adherence to oral and topi- cal medication in 3096 dermatological patients as assessed by Morisky Medication Adherence Scale-8. Br J Dermatol 2015; 172: 272–275.
[23] Alsubeeh NA, Alsharafi AA, Alaijlan A. Treatment adherence among patients with five Dermatological diseases and four treatment types- a cross-sectionnal study. Patient Preference and Adherence. 2019.
[24] Murota H, Takeuchi S, Sugaya M, Tanioka M, Onozuka D, Hagihara A, et al. Characterization of socioeconomic status of Japanese patients with atopic dermatitis showing poor medical adherence and reasons for drug discontinuation. J Dermatol Sci. 2015; 79: 279–87.
[25] La Banque mondiale. Madagascar-vue d’ensemble. [Consulté le 06 Février 2022]. Consultable à l’URL: https://www.banquemendiale.org/fr/country/madagascar/overview
[26] Wilke T, Muller S, Morisky DE,. Toward identifying the causes and combinations of causes increasing the risks of nonadherence to medical regimens: combined results of two German self-report surveys, Value Health 14 (2011) 1092–1100.
[27] Zenklusen S, Bischoff T, Panese F, Bodenmann P. Compétences en santé déficientes: obstacle à une prise encharge optimale. Revue Médicale Suisse. 2012; 1016-21.
[28] Schaarschmidt ML, Umar N, Schmieder A, et al. Patient preferences for psoriasis treatments: impact of treatment experience. J Eur Acad Dermatol Venereol. 2013; 27: 187–98.
Cite This Article
  • APA Style

    Razanakoto, N. H., Sendrasoa, F. A., Rakotoarisaona, M. F., Razafimaharo, T. I., Ramily, L. S., et al. (2024). Treatment Adherence Among Malagasy Patients with Atopic Dermatitis Seen at the Department of Dermatology, Antananarivo, Madagascar. International Journal of Clinical Dermatology, 7(1), 16-23. https://doi.org/10.11648/j.ijcd.20240701.14

    Copy | Download

    ACS Style

    Razanakoto, N. H.; Sendrasoa, F. A.; Rakotoarisaona, M. F.; Razafimaharo, T. I.; Ramily, L. S., et al. Treatment Adherence Among Malagasy Patients with Atopic Dermatitis Seen at the Department of Dermatology, Antananarivo, Madagascar. Int. J. Clin. Dermatol. 2024, 7(1), 16-23. doi: 10.11648/j.ijcd.20240701.14

    Copy | Download

    AMA Style

    Razanakoto NH, Sendrasoa FA, Rakotoarisaona MF, Razafimaharo TI, Ramily LS, et al. Treatment Adherence Among Malagasy Patients with Atopic Dermatitis Seen at the Department of Dermatology, Antananarivo, Madagascar. Int J Clin Dermatol. 2024;7(1):16-23. doi: 10.11648/j.ijcd.20240701.14

    Copy | Download

  • @article{10.11648/j.ijcd.20240701.14,
      author = {Naina Harinjara Razanakoto and Fandresena Arilala Sendrasoa and Mendrika Fifaliana Rakotoarisaona and Tsiory Iarintsoa Razafimaharo and Leophonte Samison Ramily and Rakotomanana Mbolatiana Kiady Armando and Voahanginirina Nathalie Ralimalala and Volatantely Tobiniaina Ratovonjanahary and Moril Sata and Onivola Raharolahy and Malalaniaina Andrianarison and Irina Mamisoa Ranaivo and Lala Soavina Ramarozatovo and Fahafahantsoa Rabenja Rapelanoro},
      title = {Treatment Adherence Among Malagasy Patients with Atopic Dermatitis Seen at the Department of Dermatology, Antananarivo, Madagascar},
      journal = {International Journal of Clinical Dermatology},
      volume = {7},
      number = {1},
      pages = {16-23},
      doi = {10.11648/j.ijcd.20240701.14},
      url = {https://doi.org/10.11648/j.ijcd.20240701.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcd.20240701.14},
      abstract = {Atopic dermatitis (AD) is a chronic inflammatory skin disorder characterized by intense pruritic eczematous lesions. Poor adherence to treatment is a major factor limiting treatment outcomes in patients with AD. This study aimed to assess treatment adherence in Malagasy patients with AD. It was conducted over one year in children and adult patients with AD seen at the Department of Dermatology University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar. Morisky Medication Adherence Scale-8 (MMAS-8) was used to assess patients’ treatment adherence. We included 44 children and 21 adults. The mean age was 4.29 ± 4.13 years and 35.28 ± 16.88 years, respectively. All of our patients receive topical treatment and no specific oral treatment such as biotherapy or immunosuppressant. A low adherence rate was observed in 61.90% of adult patients and the mean MMAS-8 score was 2.56 ± 1.6. In children, the mean MMAS¬8 score was 5.9 ± 1.53 and poor adherence was seen in 45.45%. The adherence level was significantly associated with age, educational status, and marital status (p < 0.05). Low treatment adherence is preponderant among Malagasy patients with AD. We did not find significant correlations between adherence levels and monthly income, frequency of follow-up, severity of AD, or insurance coverage.
    },
     year = {2024}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Treatment Adherence Among Malagasy Patients with Atopic Dermatitis Seen at the Department of Dermatology, Antananarivo, Madagascar
    AU  - Naina Harinjara Razanakoto
    AU  - Fandresena Arilala Sendrasoa
    AU  - Mendrika Fifaliana Rakotoarisaona
    AU  - Tsiory Iarintsoa Razafimaharo
    AU  - Leophonte Samison Ramily
    AU  - Rakotomanana Mbolatiana Kiady Armando
    AU  - Voahanginirina Nathalie Ralimalala
    AU  - Volatantely Tobiniaina Ratovonjanahary
    AU  - Moril Sata
    AU  - Onivola Raharolahy
    AU  - Malalaniaina Andrianarison
    AU  - Irina Mamisoa Ranaivo
    AU  - Lala Soavina Ramarozatovo
    AU  - Fahafahantsoa Rabenja Rapelanoro
    Y1  - 2024/03/13
    PY  - 2024
    N1  - https://doi.org/10.11648/j.ijcd.20240701.14
    DO  - 10.11648/j.ijcd.20240701.14
    T2  - International Journal of Clinical Dermatology
    JF  - International Journal of Clinical Dermatology
    JO  - International Journal of Clinical Dermatology
    SP  - 16
    EP  - 23
    PB  - Science Publishing Group
    SN  - 2995-1305
    UR  - https://doi.org/10.11648/j.ijcd.20240701.14
    AB  - Atopic dermatitis (AD) is a chronic inflammatory skin disorder characterized by intense pruritic eczematous lesions. Poor adherence to treatment is a major factor limiting treatment outcomes in patients with AD. This study aimed to assess treatment adherence in Malagasy patients with AD. It was conducted over one year in children and adult patients with AD seen at the Department of Dermatology University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar. Morisky Medication Adherence Scale-8 (MMAS-8) was used to assess patients’ treatment adherence. We included 44 children and 21 adults. The mean age was 4.29 ± 4.13 years and 35.28 ± 16.88 years, respectively. All of our patients receive topical treatment and no specific oral treatment such as biotherapy or immunosuppressant. A low adherence rate was observed in 61.90% of adult patients and the mean MMAS-8 score was 2.56 ± 1.6. In children, the mean MMAS¬8 score was 5.9 ± 1.53 and poor adherence was seen in 45.45%. The adherence level was significantly associated with age, educational status, and marital status (p < 0.05). Low treatment adherence is preponderant among Malagasy patients with AD. We did not find significant correlations between adherence levels and monthly income, frequency of follow-up, severity of AD, or insurance coverage.
    
    VL  - 7
    IS  - 1
    ER  - 

    Copy | Download

Author Information
  • Department of Dermatology, University Hospital Mahavoky Atsimo, Mahajanga, Madagascar

  • Department of Dermatology, University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar

  • Department of Dermatology, University Hospital of Care and Public Health Analakely, Antananarivo, Madagascar

  • Department of Dermatology, University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar

  • Department of Dermatology, University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar

  • Department of Dermatology, University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar

  • Department of Dermatology, University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar

  • Department of Dermatology, University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar

  • Department of Dermatology, University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar

  • Department of Dermatology, University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar

  • Department of Dermatology, University Hospital of Care and Public Health Analakely, Antananarivo, Madagascar

  • Department of Dermatology, University Hospital of Morafeno, Toamasina, Madagascar

  • Department of Dermatology, University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar

  • Department of Dermatology, University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar

  • Sections