Factors related to patient compliance in the treatment of acne vulgaris


Correspondence Bernard McEvoy, md, facp 7 Morris Ave Schenectady NY 12308 E-mail: bmcevoy@juno.com


Background Missed appointments are a major problem in healthcare delivery, and are one element of patient compliance with treatment.

Aim To determine whether there was a relationship between the beliefs, attitudes, expectations of treatment, and previous treatment experiences of acne patients and the keeping of follow-up appointments for treatment.

Methods One hundred and forty-four consecutive patients presenting to a private dermatologist's office for the treatment of acne completed questionnaires concerning their beliefs and previous treatment, and a record was maintained of missed appointments over a series of five scheduled appointments. A control group of middle and high school students completed the same pretreatment questionnaire. Six months after starting treatment, a second questionnaire was completed regarding compliance with treatment, problems with medication, and frequency of appointments and appointment keeping.

Results There were very few differences between patients and controls in beliefs about the cause and treatment of acne. Patient appointment keeping was as follows: 28% of acne patients attended all four follow-up appointments, 10% three follow-up appointments, 15% two follow-up appointments, 13% one follow-up appointment, and 19% no follow-up appointments. Fifteen per cent of patients dropped out of treatment for one or two appointments and then returned.

Conclusions Demographic factors, such as gender, race, method of payment for medical services, and type of therapy prescribed, were more important in determining appointment keeping behavior than were patient attitudes and beliefs, previous therapy, or severity of acne. Although there was no correlation between appointment keeping and knowledge of the condition, knowledge of the medication, severity of acne, age, or previous medical treatment, relationships were observed between demographic factors and appointment keeping.