Related Experiment Video
Updated: Jun 11, 2025
Resolving Water, Proteins, and Lipids from In Vivo Confocal Raman Spectra of Stratum Corneum through a Chemometric Approach
Published on: September 26, 2019
Treatment Adherence in Pediatric Atopic Dermatitis: A Systematic Review
Caitlyn B Dagenet1, Lauren Gawey2, Sahar Davoudi1
1University of Arizona College of Medicine, Tucson, Arizona, USA.
Insights
Improving adherence to pediatric atopic dermatitis (AD) treatment requires addressing caregiver quality of life and education. Interventions like text reminders and clear instructions significantly enhance treatment adherence in children with AD.
Area of Science:
- Dermatology
- Pediatrics
- Health Outcomes Research
Background:
- Pediatric atopic dermatitis (AD) treatment adherence is a significant challenge impacting outcomes.
- Nonadherence stems from factors like poor caregiver quality of life and inadequate education.
Approach:
- Systematic literature review of PubMed and EMBASE (2000-2023) focusing on pediatric AD adherence.
- Included 62 studies, analyzing barriers and interventions for treatment adherence in children.
Key Points:
- Identified barriers: poor caregiver QoL, insufficient AD education, topical corticosteroid (TCS) phobia, unclear instructions, and physician dissatisfaction.
- Interventions improving adherence: caregiver education, text reminders, eczema action plans, TCS traffic light system, and frequent follow-ups.
Conclusions:
- Pediatric AD adherence is multifactorial, necessitating targeted strategies for optimal outcomes.
- Effective interventions are crucial for preventing long-term sequelae of childhood AD.
- Further research is needed for adherence to emerging AD therapies.
Introduction:
Adherence to pediatric atopic dermatitis (AD) treatment regimens can be complex and a major challenge to optimizing treatment outcome. We aimed to review factors associated with nonadherence in pediatric AD and propose interventions to improve adherence.
Methods:
PubMed and EMBASE databases were systematically searched for articles from 2000 to February 2023 related to AD and adherence, with an additional update in December 2023. Non-human studies, reviews, commentaries, and meta-analyses were excluded. Articles were sorted into pediatric versus adult study population based on volume. Herein, we examine the results of papers discussing adherence factors related to pediatric patients.
Results:
A total of 62 studies met inclusion criteria. Thirty-six studies surveyed patients and caregivers (N = 10,268) to identify barriers to treatment adherence. None of the included studies were specific to systemic medications. Barriers included poor caregiver quality of life, inadequate AD-related education, topical corticosteroid (TCS) phobia, unclear therapy-related instructions, and dissatisfaction with physician interaction. Five studies solely measured adherence using medication electronic monitoring systems, Morisky medication adherence scale, or self-reported adherence to measure adherence to topical medications. Twenty-one studies described interventions involving nurse-led or web-based education programs, text message or email reminders, and TCS education. Adherence was improved with caregiver education programs, daily text-message reminders, eczema action plans, TCS potency "traffic light" color system, and frequent follow-up visits.
Conclusion:
Adherence to pediatric AD treatment poses a multifactorial challenge for caregivers and patients. This study provides an index of strategies to optimize adherence, as it is essential for prevention of long-term sequela associated with AD in children. As the AD treatment landscape rapidly expands, further studies are vital to assess pediatric adherence to new topical, oral, and injectable medications.
Trial Registration:
PROSPERO: CRD42023488557.
Related Concept Videos
01:28Drug Therapy
Antianxiety Medications
01:25Antiasthma Drugs: Mast Cell Stabilizers and Anti-IgE Drugs
Mast cell stabilizers, such as cromolyn (also known as sodium cromoglycate) and nedocromil (Tilade), are effective drugs in asthma management. These stabilizers hinder histamine release by skillfully obstructing the activation of mast cells and other cellular entities. Notably, they navigate this task without...