{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T12:45:28Z","timestamp":1765889128378,"version":"build-2065373602"},"reference-count":41,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2023,6,1]],"date-time":"2023-06-01T00:00:00Z","timestamp":1685577600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"German Society of Dermatology (DDG)"},{"name":"Arbeitsgemeinschaft Dermatologische Forschung (ADF)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Many treatments for actinic keratosis (AK) have been proven efficient in clinical trials. However, patients with AK may still experience unsatisfactory therapeutic outcomes in clinical practice. Objectives: To investigate patient adherence to self-applied topical interventions for AK and to explore factors associated with adherence in a real-world setting. Methods: A cross-sectional study was conducted. Patients presenting with AK were asked to complete a self-administered questionnaire about their last topical AK treatment. Results: A total of 113 patients participated with a median age of 78.5 years (range 58\u201394). Fifty-four patients (47.8%) received topical diclofenac, ten (8.8%) imiquimod, nine (8%) 5-fluorouracil, nine (8%) 5-fluorouracil plus salicylic acid, and eight (7.1%) photodynamic therapy. The non-adherence rate was 46.9% (n = 53), and only 30.9% (n = 35) used the topical treatments according to the summary of product characteristics (SmPC). These subgroups were compared. Patients of the non-compliant group were significantly less informed about the application time of the specific topical intervention (p = 0.002) and adjusted the timeframe (p &lt; 0.001) and application frequency of the therapy (p = 0.02) independently of their physician. Conversely, patients reporting a sufficient pre-treatment consultation (p = 0.019) generally complied with the SmPC compliance application. Conclusions: A thorough pre-treatment consultation can help to increase treatment adherence and ensure lesion clearance.<\/jats:p>","DOI":"10.3390\/jcm12113813","type":"journal-article","created":{"date-parts":[[2023,6,2]],"date-time":"2023-06-02T02:16:48Z","timestamp":1685672208000},"page":"3813","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Poor Adherence to Self-Applied Topical Drug Treatment Is a Common Source of Low Lesion Clearance in Patients with Actinic Keratosis\u2014A Cross-Sectional Study"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2005-7533","authenticated-orcid":false,"given":"Elias A. T.","family":"Koch","sequence":"first","affiliation":[{"name":"Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-University Erlangen-N\u00fcrnberg (FAU), 91054 Erlangen, Germany"},{"name":"Comprehensive Cancer Center Erlangen-European Metropolitan Area of N\u00fcrnberg (CCC ER-EMN), 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9008-0088","authenticated-orcid":false,"given":"Theresa","family":"Steeb","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-University Erlangen-N\u00fcrnberg (FAU), 91054 Erlangen, Germany"},{"name":"Comprehensive Cancer Center Erlangen-European Metropolitan Area of N\u00fcrnberg (CCC ER-EMN), 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophia","family":"Bender-S\u00e4belkampf","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-University Erlangen-N\u00fcrnberg (FAU), 91054 Erlangen, Germany"},{"name":"Comprehensive Cancer Center Erlangen-European Metropolitan Area of N\u00fcrnberg (CCC ER-EMN), 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorothee","family":"Busch","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-University Erlangen-N\u00fcrnberg (FAU), 91054 Erlangen, Germany"},{"name":"Comprehensive Cancer Center Erlangen-European Metropolitan Area of N\u00fcrnberg (CCC ER-EMN), 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janina","family":"Feustel","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-University Erlangen-N\u00fcrnberg (FAU), 91054 Erlangen, Germany"},{"name":"Comprehensive Cancer Center Erlangen-European Metropolitan Area of N\u00fcrnberg (CCC ER-EMN), 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias D.","family":"Kaufmann","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-University Erlangen-N\u00fcrnberg (FAU), 91054 Erlangen, Germany"},{"name":"Comprehensive Cancer Center Erlangen-European Metropolitan Area of N\u00fcrnberg (CCC ER-EMN), 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Maronna","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-University Erlangen-N\u00fcrnberg (FAU), 91054 Erlangen, Germany"},{"name":"Comprehensive Cancer Center Erlangen-European Metropolitan Area of N\u00fcrnberg (CCC ER-EMN), 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Meder","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-University Erlangen-N\u00fcrnberg (FAU), 91054 Erlangen, Germany"},{"name":"Comprehensive Cancer Center Erlangen-European Metropolitan Area of N\u00fcrnberg (CCC ER-EMN), 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moritz","family":"Ronicke","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-University Erlangen-N\u00fcrnberg (FAU), 91054 Erlangen, Germany"},{"name":"Comprehensive Cancer Center Erlangen-European Metropolitan Area of N\u00fcrnberg (CCC ER-EMN), 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Toussaint","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-University Erlangen-N\u00fcrnberg (FAU), 91054 Erlangen, Germany"},{"name":"Comprehensive Cancer Center Erlangen-European Metropolitan Area of N\u00fcrnberg (CCC ER-EMN), 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hedwig","family":"Wellein","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-University Erlangen-N\u00fcrnberg (FAU), 91054 Erlangen, Germany"},{"name":"Comprehensive Cancer Center Erlangen-European Metropolitan Area of N\u00fcrnberg (CCC ER-EMN), 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carola","family":"Berking","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-University Erlangen-N\u00fcrnberg (FAU), 91054 Erlangen, Germany"},{"name":"Comprehensive Cancer Center Erlangen-European Metropolitan Area of N\u00fcrnberg (CCC ER-EMN), 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4603-1825","authenticated-orcid":false,"given":"Markus V.","family":"Heppt","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-University Erlangen-N\u00fcrnberg (FAU), 91054 Erlangen, Germany"},{"name":"Comprehensive Cancer Center Erlangen-European Metropolitan Area of N\u00fcrnberg (CCC ER-EMN), 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2565","DOI":"10.1111\/jgs.16706","article-title":"The High Prevalence of Skin Diseases in Adults Aged 70 and Older","volume":"68","author":"Sinikumpu","year":"2020","journal-title":"J. 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