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

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.