Adherence to dermatologic treatment: A retrospective cross-sectional study on geriatric patients

OBJECTIVE: With the prolongation of the average life expectancy worldwide, diseases including dermatological disorders of the elderly are gaining importance. The presence of comorbidities in this age group may affect the treatment strategies; compliance with follow-up and adherence to medication can be poor. The aim of this study is to evaluate the dermatological disorders of patients aged 65 and over and determine their adherence to dermatologic treatment.
METHODS: A retrospective and cross-sectional study was conducted on patients aged 65 and over applied to a single tertiary dermatology clinic between April 2021 and April 2022. Diagnoses were that clinical and diagnostic tests were performed when only necessary.
RESULTS: A total of 207 admissions to the dermatology clinic by 135 patients were evaluated. Eczema (23.05%) and infections (25.2%) were the most common dermatological diagnoses. The percentage of patients with precancerous and cancerous lesions was 11.9%. Among 123 patients who need at least a follow-up visit, only 37 patients (30.1%) applied for follow-up as advised, and medicines were taken regularly by 23 of these patients (62.2%). Compliance with follow-up was lower among men (OR 0.365, 95% CI 0.160–0.834, and p=0.02) and patients who were treated only with local therapy agents (OR 0.345, 95% CI 0.138–0.863, and p=0.20).
CONCLUSION: Eczema and infections were the most common dermatological diagnoses among geriatric patients in the present study. The majority of geriatric patients with skin conditions were not applying for follow-up visits. Women and patients treated with systemic therapy agents were more compliant. The prevalence of basal cell carcinoma was not low, and this emphasizes the importance of a careful dermatological examination regardless of primary complaint in this age group.

Dermatolojik tedaviye uyum: Geriatrik hastalar üzerine retrospektif kesitsel bir çalýþma

Amaç: Tüm dünyada ortalama yaþam süresinin uzamasýyla birlikte yaþlý hastalarda görülen dermatolojik hastalýklar dahil olmak üzere tüm hastalýklar önem kazanmaktadýr. Bu yaþ grubunda dermatolojik hastalýklara sýklýkla eþlik eden sistemik hastalýklarýn varlýðý tedavi seçimlerini etkileyebilir; ilaç kullanýmýna ve takibe uyum zayýf olabilir. Bu çalýþmada amaç 65 yaþ ve üzeri hastalarýn dermatolojik hastalýklarýný deðerlendirmek, klinik kontrollere ve ilaç tedavisine uyumlarýný belirlemek.
Yöntem: Nisan 2021 ile Nisan 2022 tarihleri arasýnda tek bir üçüncü basamak dermatoloji kliniðine baþvuran 65 yaþ ve üzeri hastalarda retrospektif kesitsel bir çalýþma yapýlmýþtýr. Tanýlar kliniktir ve tanýsal testler sadece gerektiðinde yapýlmýþtýr.
Bulgular: Dermatoloji polikliniðine baþvuran135 hastanýn toplam 207 baþvurusu deðerlendirildi. Ekzema (%23) ve deri infeksiyonlarý (%25,2) en sýk dermatolojik tanýlardý. Prekanseröz ve kanseröz deri lezyonlarý olan hastalarýn tüm gruba oraný %11,9 olarak bulundu. Takip ihtiyacý olan 123 hastadan sadece 37'si (%30,1) tavsiye edildiði þekilde kontrole gelmiþti ve bu hastalarýn 23'ü (%62,2) düzenli olarak ilaçlarýný kullanmýþtý. Takibe uyum erkekler (OR 0,365, %95 CI 0,160-0,834, p=0,02) ve sadece topikal tedavi kullanýlan hastalar arasýnda daha düþük bulundu (OR 0,345, %95 CI 0,138-0,863, p=0,20).
Sonuç: Ekzema ve deri infeksiyonlarý bu çalýþmanýn geriatrik hastalarýnda en sýk görülen dermatolojik tanýlardýr. Deri þikayetleri olan geriatrik hastalarýn çoðu planlý kontrollerini takip etmemektedir. Kadýnlar ve sistemik tedavi ajanlarýyla tedavi edilen hastalar daha uyumlu bulunmuþtur. Bazal hücreli karsinom prevalansýnýn düþük olmamasý, bu yaþ grubunda birincil þikayete bakýlmaksýzýn dikkatli bir dermatolojik muayenenin önemini vurgulamaktadýr. (NCI-2022-6-23)