Identifying individual psychosocial and adherence support needs in patients with psoriasis: a multinational two‐stage qualitative and quantitative study

Abstract

BackgroundPsoriasis has a serious impact on patients’ lives. However, adherence to medications is often poor, potentially compounding the burden of disease. Identifying patients who need support with psychosocial problems, or issues with adherence, can be complex.ObjectivesWe aimed to develop statements that could assist the consultation process, identifying the relative importance of factors related to effective management of psoriasis for patients.MethodsA two-stage study design was used to comprehensively identify, and assess validity of, statements describing psoriasis impact and management issues. Both components were conducted in Canada, France, Germany, Italy, Spain, the United Kingdom and the United States. Findings from patient observation and interviews were analysed for pattern strength, and were then used to inform the development of statements that were quantitatively assessed using a survey. The association of drivers towards agreement with ‘my psoriasis dictates how I lead my life’ was assessed using anova.ResultsFifty-six patients participated in the qualitative component, and 1,884 patients using prescription medications completed the survey. Two thematic categories were identified; disappointment with treatments, and confusion regarding psoriasis associated with a lack of direction. When assessed quantitatively, key statements associated with a strong burden of psoriasis on patients’ lives were related to isolation, social stigma, visible symptoms, impact on activities and feelings of hopelessness. A mixture of patient-, doctor- and treatment-related factors were among the most common reasons for non-adherence.ConclusionQuestioning using the statements most associated with psychosocial impact and non-adherence could help identify patients with additional support needs, and assist in overcoming adherence issues.

Topical treatment of psoriasis: questionnaire results on topical therapy accessibility and influence of body surface area on usage

“…It has previously been shown that among patients with a BSA of 3 or below, 22% of the patients reported they had severe psoriasis . In addition, a substantial burden of disease severity can also be attributed to psoriasis treatment . Thus, treatment adherence is often a challenge as demonstrated in reports that up to 50% of prescriptions for topical therapies are never filled .…”

Real‐life effectiveness of once‐daily calcipotriol and betamethasone dipropionate gel vs. ointment formulations in psoriasis vulgaris: final analysis of the 52‐week PRO‐long study

“…This is a challenge in psoriasis as topicals are the mainstay of treatment for mild‐to‐moderate disease . A real‐life study showed that 46% of psoriasis patients were not fully adherent to their prescribed topical therapy, applying treatment only when they felt it necessary . The choice of vehicle is one of the key factors affecting patient adherence to topical psoriasis treatment.…”

The Meaning of Coping With Psoriasis: A Phenomenological Study

“…However, none of them had inner satisfaction and showed their ambivalent feelings in words such as "forced veiling" and "even though I don't like gloves" and similar sentences that show ambivalent feelings were more because of the concern of social exclusion, which was mentioned in the study of Bewley et al (27). Rapp et al (2001) (30) mentioned in this regard that coping with a rare chronic disease is difficult.…”

“…Undoubtedly, reasonable adaptation and accepting the reality is the most suitable possible situation. People, who adapt to the disease, actively participate in the process of compliance with this disease, and on the contrary, patients, who do not adapt with their disease, suffer from hopelessness, despair and loneliness (27).…”