RESUMEN
Co-morbidities are characterized by the presence of multiple chronic diseases within a single individual. They pose an escalating healthcare challenge and managing this growing burden, particularly with non-communicable diseases, has become a major concern. However, a significant impediment to effective management lies in medication nonadherence. The importance of medication adherence has long been a focus of healthcare literature, yet many comorbid patients tend to underestimate its significance, leading to health deterioration. Research studies indicate alarmingly low adherence rates in comorbid patients. To address this issue, patient education and healthcare campaigns have become essential tools in enhancing adherence. The research, which commenced on October 19, 2023, was initiated after an exhaustive review of existing academic literature. Multiple databases, such as PubMed, Web of Science, and Cochrane, were employed for this comprehensive literature review, utilizing a wide array of medical terminology combinations. The study aims to shed light on potential strategies and educational approaches to enhance medication adherence in comorbid patients. Findings from this research have the potential to influence healthcare policy, the design of tailored interventions, and overall healthcare delivery improvements for co-morbid patients, ultimately leading to enhanced health outcomes, reduced costs, and an improved quality of life.
RESUMEN
Background: The localized form of granuloma annulare is usually self‑limiting, resolving within 2 years. Generalized granuloma annulare, on the other hand, runs a protracted course, with spontaneous resolution being rare. It is also characterized by a later age of onset, an increased incidence of diabetes mellitus, poor response to therapy, and an increased prevalence of HLA Bw35. Objective: To assess the efficacy of monthly pulsed rifampicin, ofloxacin, and minocycline (ROM) therapy in the management of granuloma annulare.Methods: Six biopsy proven patients of granuloma annulare were included in the study, five of the generalized variety, and one localized. Three of these patients were resistant to standard modalities of treatment. All six patients were treated with pulses of once monthly ROM till complete resolution of all lesions. Results were analyzed in terms of complete resolution of lesions and side effects. Presence of comorbid conditions was noted. Result: All six patients were successfully treated with 4-8 pulses of monthly ROM. None of the patients reported any adverse effects. Limitations: Small sample size and the lack of a control group are limitations. Conclusion: Treatment with pulses of once monthly ROM caused complete resolution of lesions in both localized and generalized granuloma annulare, even in cases recalcitrant to conventional therapy. There were no side effects in any of the patients. Larger trials are needed to substantiate the efficacy of monthly ROM in granuloma annulare.