This research aimed to explain the adherence to treatment among patients with scleroderma. The findings revolved around adherence to treatment in scleroderma patients, in two categories of “diagnostic-therapeutic regimen as the basis for adherence to treatment” and “adherence to a range of physical care”.
The patients valued the use of diagnostic methods and emphasized that the tests should be performed on time and at the right time. According to them, patients should not refuse to perform diagnostic methods such as skin biopsy, skin sensitivity test, and CT scan, and should be committed to performing them properly and regularly.
To prevent the disease from flaring up, they recommended continuous follow-up and not abandoning the doctor's orders, and following the drug regimen and healthcare recommendations fully and continuously.
In this regard, Najm et al. (2022) showed that conducting specialized tests such as advanced neuroimaging and genetic studies and updating them at different levels of histopathological diagnosis of the focal cerebral cortex dysplasia is essential and can strengthen multidisciplinary efforts and help develop new targeted therapeutic options [18].
Similarly, Bailey et al. (2021) showed that regular follow-up of treatment plans using test results is among the key strategies used at each stage of treatment to improve adherence to treatment. [19].
The results of the study by Pietrzykowski et al. (2022) revealed a relationship between patients’ expectations and long-term adherence to treatment. [20].
In this study, patients paid attention to physical care, including monitoring their weight, taking care of the skin by rubbing oil and moisturizer, and trimming the extra skin behind the nails.
Also, for their comfort and to resolve bruises in the fingers, they tried to keep the body warm and wear gloves, refrain from hydrotherapy, reduce the number of baths, and use water with a suitable temperature tolerable for the body. They also adhered to sunbathing after taking a shower, wearing warm clothes in winter, wearing gloves and socks, and avoiding cold and wind.
Davies et al. (2022) concluded that health system care and physical activities with more emphasis on weight control management are considered part of comprehensive care management in diabetic patients [21].
The study by Esubalew et al. (2022) indicated that self-care in patients with podoconiosis was not well performed, and since social and demographic factors are known as factors related to self-care performance, strengthening health education and behavioral changes is necessary to improve self-care performance [22].
Previous studies are in line with the present research. Evidently, paying attention to, reminding, and teaching patients about self-care has a marked effect on their follow-up and adherence to treatment.
As for the selection of nutritional patterns appropriate to the condition of the disease, the patients emphasized the use of healthy and natural food with a warming characteristic and refraining from consuming cooling food, leftovers, fried foods, pickles, stimulants, fast food, veal, canned foods, and flatulent and fatty foods, and less use of dairy, reducing the volume and increasing the frequency of meals.
Mesquida et al. (2022) concluded that greater adherence to the Mediterranean diet leads to greater improvement in patients with non-alcoholic fatty liver and the reduction of cardiac, respiratory, metabolic, and inflammatory problems[23].
Rahimlou et al. (2022) stated that the level of adherence to the Mediterranean diet has an inverse relationship with hypertension. [24].
Some patients with a tendency towards complementary medicine attached special importance to the use of traditional procedures, the oral and topical use of medicinal plants, and the use of organic and traditional substances for prevention and treatment.
Ding et al. (2020) noted that patients' adherence to complementary medicine can be effective in their adherence to treatment.[25].
Inoue-Choi et al. (2022) in a large-scale study on smoking patients showed that following healthy lifestyle recommendations was associated with a lower risk of mortality. [26].
The cited studies are all in line with the improvement of adherence to treatment and the current research; accordingly, strengthening adherence to treatment and facilitating conditions along with recognizing and removing obstacles can have a significant impact on improving adherence to treatment. In this way, we can reduce complications and witness patient recovery.
On the other hand, Rajahthurai et al. (2022) showed that the use of complementary medicines in stroke patients is at a low level due to limited knowledge and the high number of medical drugs.[27].
Hashemi et al. (2018) introduced the most important barriers to adherence to treatment as the poor performance of the healthcare team, social bottlenecks, and personal helplessness. According to them, the best strategies for increasing adherence to treatment in patients with diabetes were increasing their performance and motivation in adhering to the therapeutic regimen by removing obstacles such as fear and inappropriate feedback and promoting satisfaction, support, knowledge about the disease and test results, and giving importance to the timely control of complications.[11].
In general, based on the findings of Gregorian et al.'s study (2022), creating positive beliefs along with a sense of responsibility and involving families can facilitate adherence to long-term treatments and promote the successful completion of treatment [28].