2019 Volume 11 Issue 1 Pages 44-52
Patients’ compliance to medication influences the outcome of treatments. In onychomycosis treatment, the introduction of efinaconazole topical solution seemed that problems such as long-term administration, side effects, and drug interactions of internal medicine could be solved and eventually avoiding deterioration of adherence. However, the percentage of patients who terminated the medication just after the initial treatment was significantly higher (45.3%) in those treated with efinaconazole alone than those treated with efinaconazole in combination with internal medicine (5.9%) (p=0.002). In addition, it was found that 15.4% of the patients who received guidance using a home-made instruction sheet stopped taking efinaconazole after the initial treatment, while significantly higher percentage of patients (46.2%, p=0.004) without a guidance terminated the medication by patients’ self-judgment. It was shown that the therapeutic effect of efinaconazole varied depending on how it was applied. For example, the group of patients (91.7%) who applied higher dose per an administration and those (80.6%) who applied the drug not only to the nails but also to the skin under and surrounding the nails obtained a better treatment outcome. Efinaconazole was also shown to be useful (79.4%) for severe cases (lesion area>50%) which were excluded in the clinical trial. It should be noted that pharmacists could have a significant role in improving patients’ adherence to efinaconazole treatment by using a specifically prepared instruction sheet.
