Patient-reported outcomes in topical field treatment of actinic keratosis in Swedish and Danish patients

Abstract

Topical treatments in dermatology can be long, complex and lead to nonadherence and nonpersistence to prescribed treatment. Clinical efficacy observed in randomized clinical trials (RCT) may therefore be reduced in real-world clinical practice. The objective of this study was to analyze patient-reported treatment adherence, treatment satisfaction and health-related quality of life (HRQoL) with topical treatments of actinic keratosis (AK) in routine clinical practice in Denmark and Sweden. Adult patients prescribed field-directed topical AK treatments with diclofenac gel, imiquimod or ingenol mebutate per routine clinical practice were eligible for the observational RAPID-ACT study. Data were collected through physician and patient questionnaires that included validated instruments to measure treatment satisfaction (TSQM-9), treatment adherence (MMAS) and HRQoL (EQ-5D-5L, EQ-VAS, AKQoL). In total, 446 patients from Denmark and Sweden were included. Ingenol mebutate patients reported a higher satisfaction with treatment effectiveness compared to patients treated with diclofenac (p = .006) while no other differences in treatment satisfaction could be determined. Treatment adherence was generally high, but higher for ingenol mebutate compared to both diclofenac (p < .001) and imiquimod (p = .007), possibly due to shorter treatment duration. No differences in improved HRQoL were found. More research is needed about the link between treatment adherence and real-world effectiveness.

Assessment of medication adherence and treatment satisfaction in Japanese patients with psoriasis of various severities

“…The TSQM‐9 is a reliable instrument to assess patients' satisfaction with treatment. It has been used to assess the treatment satisfaction in various diseases such as pulmonary arterial hypertension, multiple sclerosis, psoriasis vulgaris, diabetes mellitus, asthma, allergic rhinitis and actinic keratosis . Bagel et al .…”

“…It has been used to assess the treatment satisfaction in various diseases such as pulmonary arterial hypertension, multiple sclerosis, psoriasis vulgaris, diabetes mellitus, asthma, allergic rhinitis and actinic keratosis. [10][11][12][13][14][15] Bagel et al 12 used the TSQM-9 to evaluate the treatment satisfaction with a topical suspension of calcipotriene and betamethasone dipropionate in patients with psoriasis vulgaris and reported that, at the end of the 8-week treatment, the mean TSQM-9 scores for effectiveness, convenience and global satisfaction domains ranged 68-74. To the best of our knowledge, this is the first study to assess TSQM-9 scores in psoriatic patients who were treated not only with topical drugs but also systemic treatments including biologics.…”

Treatment satisfaction in atopic dermatitis relates to patient‐reported severity: A cross‐sectional study

“…The TSQM‐9 focuses specifically on the three domains of Effectiveness, Convenience, and Global Satisfaction . The TSQM‐9 has been used to assess treatment satisfaction for some diseases but has not yet been applied to atopic dermatitis.…”

Use of complete clearance for assessing treatment efficacy for 5-fluorouracil interventions in actinic keratoses: how baseline lesion count can impact this outcome

“…This outcome was mentioned as critically important by 79% of participating experts, and 54% of participating patients considered dosage adherence as critically important. Topical dermatology treatments are often challenging due to prolonged and complex treatment regimens and can often lead to treatment nonadherence [ 19 , 20 ]. Therefore, efforts to maximize treatment compliance should be encouraged [ 19 ].…”