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0:00
Hi, I'm Dr. Steven Feldman,
Professor of
Dermatology, Pathology,
and Public Health
Sciences here at
the Wake Forest University
School of Medicine
in beautiful Winston-Salem,
North Carolina.
It's my pleasure to
talk to you about
the importance of adherence
in the treatment of psoriasis.
This is an exciting topic
across all of medicine.
This is not your
parents' adherence talk.
We're going to discuss data on
how poorly patients
use their medicines
and practical things
we can do about it.
0:30
Here is my list of disclosures.
If I mention a product,
I've probably had some support
from the company that
makes that product.
0:39
In this presentation,
I'll be discussing
how bad adherence is and
the implications of it
and why I think
adherence is bad,
and this is a little
bit of a teaser,
I think it's because
physicians aren't that good
at getting people to
use the medicines
as I'll try to prove to you.
But we can be much better at it.
0:60
Let's talk about how
bad adherence is.
1:05
First, what is adherence?
I used to think it was
the number of times
people took the medicine.
But we can actually think
about it in a couple of ways.
First, do they fill the
prescription that we give them?
If they do, do they
start the therapy?
We'll call that
primary adherence.
Then, secondary adherence is
how well they use
the medication.
They may not fill prescriptions.
They may not use
the medicine well.
They may discontinue early.
A lot of that happens in
psoriasis management.
1:34
I think one of the
best studies done
on adherence in the
world of dermatology was
a study done in Denmark
where they gave
patients' prescriptions,
and then they
followed up with the
Danish pharmacy databases,
where there's one pharmacy
database for the whole country,
a month later to see when the
prescriptions were filled.
And 90% of acne and
infection prescriptions
were filled in two weeks,
which may sound pretty good,
but it's terrible that 10% of
prescriptions don't get filled.
For atopic dermatitis,
about a third of the
prescriptions didn't get filled,
and for psoriasis, I think
half the prescriptions
didn't get filled.
I think it's largely
because patients were
prescribed greasy ointments
that they didn't want to use,
and so they didn't fill
the prescriptions.
