Review: timing of office visits can be a powerful tool to improve adherence in the treatment of dermatologic conditions

Abstract

Background: Poor adherence to treatment is a significant problem throughout medicine and particularly in the treatment of dermatologic conditions with topical medications, which present unique barriers to adherence. Purpose: We reviewed the literature to assess whether timing of office visits can be used to improve adherence. Methods: Studies examining adherence and office visits were identified using two search engines. PubMed was searched using the terms “medication adherence” OR “medication compliance” AND “visits.” A Web of Science® cited reference search was performed to identify articles referencing the paper “On White-Coat Effects and the Electronic Monitoring of Compliance” by Alvan R. Feinstein, MD. Results: Fifteen studies were identified, three of which were on dermatologic conditions. Thirteen studies found a positive correlation between adherence and office visits. Three of these studies demonstrated increased adherence with increased visit frequency. One study reported adherence was unaffected by office visits. Limitations: Our review was limited in that none of the studies identified looked at the effect timing of office visits had on adherence in the long term. Conclusions: Strategic scheduling of office visits can be a valuable tool to improve adherence, particularly in the management of dermatologic conditions, and may help spare patients unnecessary exposure to more toxic systemic therapies.

Key words::

• white coat compliance
• compliance
• adherence
• treatment outcomes
• follow-up visits
• return visits

Acknowledgements

The Center for Dermatology Research is supported by an educational grant from Galderma Laboratories, L.P. Dr. Feldman is a consultant and speaker for Galderma Laboratories, L.P., Connetics Corporation, Abbott Laboratories, Warner Chilcott, Centocor, Amgen, Photomedix, Genentech, Biogenidec, and Bristol-Myers Squibb. Dr. Feldman has received grants from Galderma Laboratories, L.P., Connetics Corporation, Astellas, Abbott Laboratories, Warner Chilcott, Centocor, Amgen, Photomedex, Genentech, Biogenidec, Coria, Pharmaderm, Dermatology Foundation, American Society of Dermatologic Surgery, National Psoriasis Foundation, Ortho Pharmaceuticals, Aventis Pharmaceuticals, Roche Dermatology, 3M, Bristol-Myers Squibb, Stiefel, GlaxoSmithKline, and Novartis and has received stock options from Photomedix. Dr. Levender and Elizabeth Heaton have no conflicts to disclose.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.