Phototherapy Adherence Among Patients With Different Indications

Phototherapy has a long history in dermatology, but studies on patient adherence are scarce. Existing research mainly covers secondary adherence, lacking data on primary adherence. This study investigates factors influencing primary and secondary treatment adherence in phototherapy patients.

The study was conducted at Ankara University's Department of Dermatology. While investigating compliance with primary adherence, sociodemographic, disease-related characteristics, and reasons for rejection of patients who refused treatment were noted. Secondary compliance was investigated by following the patients who accepted the treatment; additionally, treatment-related factors and center-related aspects were questioned.

Higher education and income levels correlated with better primary treatment adherence. Longer travel distances and durations reduced adherence. Adherence was lowest among psoriasis patients. Longer disease duration, particularly over 10 years, increased rejection rates. Disease in exposed areas increased primary adherence; conversely, facial involvement decreased secondary adherence. Higher life quality scores correlated with better primary but lower secondary adherence. Being treatment-naive or appearance-focused increased primary adherence. Irregular past topical/systemic treatments reduced primary/secondary adherence. Distance and work-related issues were common refusal reasons. Side effects occurred in 19.2%: hyperpigmentation/lentigo (9.6%), erythema (5.8%), and dryness/itching (4.8%). Treatment adherence rates were 63.8% (primary), 91.3% (secondary), and 53% (overall).

According to our understanding, this is the first study in the literature investigating primary treatment adherence in phototherapy. With its prospective design, the study also facilitated the collection of follow-up data and covers various indications, offering insights into factors enhancing treatment compliance and success in phototherapy patients.