Director of Continuing Medical Education, Clinical Instructor, Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada.
Abstract: While topical therapy remains a key therapeutic approach in the clinical management of AV, it can be associated with side effects that may compromise the stratum corneum and impair patient adherence. The use of adjunctive cleansers and moisturizers can help mitigate treatment side effects and subsequently enhance therapeutic efficacy. Providing patient-specific skin care recommendations, including product selection and proper use, is an important part of the clinical management of AV and may adjunctively augment the efficacy of topical medications in reducing acne lesions.
Irritation resulting from topical medications and the emergence of bacterial resistance to both topical and oral antibiotics remain significant barriers to good treatment adherence.
Providing patient-specific skin care recommendations, including product selection and proper use, is an important part of the clinical management of AV and may adjunctively augment the efficacy of topical medications in reducing acne lesions.
Alleviating dryness and improving skin comfort by using a moisturizer concomitantly with retinoid therapy could enhance treatment efficacy.
The adjunctive use of appropriate gentle soap-free cleansers and non-comedogenic moisturizers that also restore SC barrier function, provide SPF protection, and reduce side effects of topical acne therapy is recommended and is preferred by patients and will likely improve treatment adherence.
Topical dapsone gel is antimicrobial and antineutrophilic and new fixed-dose retinoid-based combination therapies are available and this allows us to improve adherence with therapy and target multiple pathogenic mechanisms with one treatment.
Oleosome technology enables the delivery of broad-spectrum UVA/UVB sun protection (SPF 30). This technology effectively reduces the concentration of filters being applied to the skin, reducing the potential for skin sensitivity reactions.
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Adherence to Medication in Patients with Dementia: Problems and Solutions
Teaser:
Daniel J. Brauner, MD, Department of Medicine/Geriatrics, University of Chicago, Chicago, IL, USA.
Lack of adherence is a major reason for the failure of medical therapies and is an especially important and sometimes underappreciated issue for the growing number of people with dementia. The factors that tend to affect adherence in persons with dementia have begun to be appreciated and have implications for patients more generally. Strategies for improving adherence in patients with dementia based on their cognitive problems are discussed. Increased awareness of adherence will encourage physicians to create more reasonable and simplified medical regimes and promote the use of aids for improving adherence, which can also be used with cognitively intact patients. Key words: dementia, adherence, medication management capacity.
