Phototherapy adherence among patients with different indications

Aim: Phototherapy has been used successfully in dermatology for decades, yet studies investigating patient compliance are limited in the literature. Since existing studies have focused on secondary adherence, in current literature, there is no data on primary treatment adherence. In this study, it was aimed to investigate the factors affecting both primary and secondary treatment adherence in patients who are suitable for phototherapy regardless of indication. Materials and Methods: Study was carried out in Ankara University Department of Dermatology and Venereal Diseases between March 2022- February 2023 and 207 patients over 18 years old were included 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. Results: Of the patients, 81 (39.1%) were male and 126 (60.9%) were female. Their ages ranged from 18 to 81, with a mean of 50.80±14.69 years. It was found that primary treatment adherence increased as education level and mean monthly income increased. Employees in the private sector had a higher rejection rate than those working in the public sector; rejection rate of the unemployed was significantly higher than the retirees. It was found that an increase in distance and time of arrival decreased primary treatment adherence. Both primary and secondary treatment adherence of psoriasis patients was lower than other diseases. Prolongation in disease duration, particularly above 10 years, increased treatment rejection rates. Disease in exposed areas increased primary treatment compliance, conversely facial involvement decreased secondary treatment compliance. Increase in DLQI scores was directly correlated with primary adherence, inversely correlated with secondary adherence. Being treatment naive or seeking treatment for appearance also increased primary treatment adherence. Primary treatment adherence was low in people who stated that they used previous topical treatments irregularly, secondary treatment adherence was low in those stated that they used previous systemic treatments irregularly. For patient reluctant to systemic treatment, primary treatment adherence was higher while secondary treatment adherence was found to be lower. The most common reasons for refusal were distance and work-related. The rate of side effects was found to be 19.2%. Hyperpigmentation or lentigo developed in 9.6% of the patients, erythema in 5.8% and dryness and itching in 4.8%. At the end of the study, primary treatment adherence in phototherapy was 63.8%, secondary treatment adherence was 91.3%, and overall treatment adherence was 53%. Conclusion: According to our understanding, this is the first study in the literature investigating primary treatment adherence in phototherapy. It is also the first data showing phototherapy treatment adherence in Turkey. With its prospective nature, patient follow-up data in the treatment areas are also stated. Another difference of the study is that it includes many different indications. The factors that can increase treatment compliance and success with a holistic approach to phototherapy patients have been brought to the literature