Non‐adherence and measures to improve adherence in the topical treatment of psoriasis

Zschocke, I.; Mrowietz, Ulrich; Karakasili, Eleni; Reich, Kristian

doi:10.1111/jdv.12445

Cited by 66 publications

(62 citation statements)

References 53 publications

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“…Moreover, they identified that prescribing therapy in line with patient preferences or improving patient education may result in increased adherence. Similarly, Zschocke et al33 established that the reasons for non-adherence to treatment amongst psoriasis patients revolve mainly around treatment vehicle, patient–physician relationship or patient motivation. These authors propose that given that the barriers to medication adherence are complex and varied, solutions to improve adherence should be multifaceted and allow tailoring according to each patient’s individual needs.…”

Section: Resultsmentioning

confidence: 99%

Adherence, satisfaction and preferences for treatment in patients with psoriasis in the European Union: a systematic review of the literature

Belinchón¹,

Rivera²,

Blanch³

et al. 2016

PPA

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Background and objectiveAdherence to treatment in patients with psoriasis is often poor. An investigation of patient preferences and satisfaction with treatment may be important, based on the expected correlation with therapy compliance. This paper aims to examine and describe the current literature on patient preferences, satisfaction and adherence to treatment for psoriasis in the European Union (EU).MethodsElectronic searches were conducted using PubMed, ISI Web of Knowledge, Scopus, Spanish databases and Google Scholar. European studies published in English or Spanish between January 1, 2009 and December 31, 2014 regarding patient-reported outcomes in psoriatic patients were included. Studies conducted in non-EU countries, letters to the editor, editorials, experts’ opinions, case studies, congress proceedings, publications that did not differentiate between patients with psoriasis and psoriatic arthritis or studies related to specific treatment were excluded.ResultsA total of 1,769 titles were identified, of which 1,636 were excluded as they were duplicates or did not provide any relevant information. After a full-text reading and application of the inclusion/exclusion criteria, 46 publications were included. This paper will describe publications on adherence (n=4), preferences (n=5) and satisfaction with treatment (n=7). Results related to health-related quality of life articles (n=30) have been published elsewhere. Adherence rates are generally low in psoriasis patients regardless of the type of treatment, severity of disease or methods used to measure adherence. Biologic therapy is associated with greater clinical improvement. There is a direct association between physician recommendations, patient preferences and several domains of treatment satisfaction.ConclusionThe results of this review support the conclusion that adherence rates in patients with psoriasis are suboptimal and highlight the need to improve patient compliance and satisfaction with treatment. Patients’ preferences should be taken into account in the treatment decision-making process in order to improve patients’ clinical outcomes by ensuring satisfaction and adherence.

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Section: Resultsmentioning

confidence: 99%

Adherence, satisfaction and preferences for treatment in patients with psoriasis in the European Union: a systematic review of the literature

Belinchón¹,

Rivera²,

Blanch³

et al. 2016

PPA

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“…Poor patient perception of effectiveness and concerns around the topical treatment formulation are drivers of inadequate adherence 30. Preference data indicate that a greater proportion of patients receiving Cal/BD aerosol foam than Cal/BD gel thought it was more effective, easier to apply and generally preferred it compared with previous topical and systemic therapies.…”

Section: Discussionmentioning

confidence: 99%

Calcipotriol plus betamethasone dipropionate aerosol foam provides superior efficacy vs. gel in patients with psoriasis vulgaris: randomized, controlled PSO‐ABLE study

Paul

Gold

Cambazard

et al. 2016

Acad Dermatol Venereol

104

167

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BackgroundFixed combination calcipotriol 50 μg/g (Cal) plus betamethasone 0.5 mg/g (BD) foam has been developed as a new treatment option for patients with psoriasis.MethodsThe randomized, parallel‐group, investigator‐blinded Phase III, 12‐week PSO‐ABLE study compared the efficacy and safety of Cal/BD foam with Cal/BD gel. Patients aged ≥18 years with mild‐to‐severe psoriasis were randomized 4:4:1:1 to once‐daily Cal/BD foam, Cal/BD gel, foam vehicle or gel vehicle (NCT02132936). The primary efficacy endpoint was the proportion of patients who were clear/almost clear with a ≥ 2 grade improvement according to the physician's global assessment of disease severity (i.e. treatment success) at week 4 for Cal/BD foam vs. week 8 for Cal/BD gel. Secondary efficacy endpoints included: proportion of patients achieving at least a 75% reduction in modified psoriasis area and severity index (mPASI75), and time to treatment success (TTTS). Safety was monitored throughout.ResultsA total of 463 patients were randomized: Cal/BD foam (n = 185), Cal/BD gel (n = 188), foam vehicle (n = 47), gel vehicle (n = 43); overall completion rate was 90%. Cal/BD foam achieved higher treatment success rates (38% vs. 22%; P < 0.001) and mPASI75 (52% vs. 35%; P < 0.001) by week 4 than Cal/BD gel by week 8. Median TTTS with Cal/BD foam was 6 weeks; this could not be determined for Cal/BD gel as 50% treatment success was not achieved (P < 0.001). Adverse drug reactions were reported in 14 (7.6%) Cal/BD aerosol foam patients and 7 (3.7%) Cal/BD gel patients; all were single events except for itch with Cal/BD aerosol foam (n = 5; 2.7%) and worsening psoriasis with Cal/BD gel (n = 3; 1.6%).ConclusionCal/BD aerosol foam showed significantly greater efficacy after 4 weeks, than 8 weeks of treatment with Cal/BD gel, with similar tolerability.

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“…As the physician-patient relationship is the strongest predictor of adherence, such soft factors might even be the crucial ones [14,18,30,31,32,33,34]. Auxiliary strategies to improve adherence to topical treatment have been suggested [1,18,35,36], including: look patients in the eyes, use the patients' own words, give only 3 take-home messages, keep the regimen as simple as possible, explore the most accepted vehicle, avoid alarmist messages (‘use sparingly'), explain the fingertip unit method [17], provide written instructions [8], and, if desired, provide demonstration of therapy by specialised dermatology nurses [8,37] and group-based learning [1,22,38]. …”

Section: Discussionmentioning

confidence: 99%

Topical Corticosteroid Concerns in Dermatological Outpatients: A Cross-Sectional and Interventional Study

Müller

Tomaschett²,

Euler³

et al. 2016

Dermatology

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Background/Aims: Topical corticosteroid concerns (TCC) are an important issue in patients with atopic dermatitis, leading to non-adherence with poor disease control and increased health care costs. However, neither the prevalence of TCC in a more comprehensible dermatological population nor the impact of patient information on topical corticosteroids given by clinicians is known. Therefore, we assessed the prevalence, characteristics, and sources of TCC in a dermatological population and the impact of written and oral patient information on TCC. Methods: A total of 643 outpatients with various skin diseases answered a 12-item questionnaire while waiting for the doctor's visit. Patients with TCC quantified their concerns on a discrete visual analogue scale before and after patient information, which consisted of written and oral information about topical corticosteroids (TCS) given by dermatologists. Results: The prevalence of TCC was 41.5%, and that of TCC-related non-adherence was 28.3%. TCC was positively associated with age <60 years, female gender, use of complementary and alternative medicine (CAM) and non-physician health care profession. The leading concerns were skin atrophy, systemic effects, and impairment of the immune system. The most frequent sources of TCC were negative reports by media, family, or friends. Both written and oral patient information significantly reduced TCC. The number needed to benefit from patient information was approximately 2. Non-responders were more often female, TCS-inexperienced, and users of CAM with an intermediate level of education. Conclusions: TCC are highly prevalent in dermatological patients. Patient information may lower TCC in almost every second patient.

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Non‐adherence and measures to improve adherence in the topical treatment of psoriasis

Cited by 66 publications

References 53 publications

Adherence, satisfaction and preferences for treatment in patients with psoriasis in the European Union: a systematic review of the literature

Adherence, satisfaction and preferences for treatment in patients with psoriasis in the European Union: a systematic review of the literature

Calcipotriol plus betamethasone dipropionate aerosol foam provides superior efficacy vs. gel in patients with psoriasis vulgaris: randomized, controlled PSO‐ABLE study

Topical Corticosteroid Concerns in Dermatological Outpatients: A Cross-Sectional and Interventional Study

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