Time Needed for Treatment Is the Major Predictor of Quality of Life in Psoriasis

Abstract

Background: The literature on predictors of health-related quality of life in psoriasis is inconsistent. Objective: To assess potential predictors of quality of life in psoriasis. Methods: In a cross-sectional study involving 130 dermatological practices and outpatient clinics, data of 1,210 patients with psoriasis were collected. Quality of life was evaluated using the Dermatology Life Quality Index. Medical history, clinical and sociodemographic characteristics, therapy and health care features were used as independent variables in a backward multiple regression analysis. Results: Twelve predictors were included in the model explaining 38% of variance in quality of life. The strongest predictor was daily treatment time (β = 0.30), followed by patient-defined treatment benefit (β = –0.18), disease severity (β = 0.19) and treatment satisfaction (β = –0.16). Conclusion: Treatment burden requires special attention when quality of life in psoriasis is to be improved. Since the larger part of variance is left unexplained, further factors predicting quality of life have yet to be detected.

Characterization of Patient-Reported Outcomes in Moderate to Severe Psoriasis

“…Another study found that females showed lower HRQoL and that lower HRQoL was also correlated with lower age [12]. In the study by Blome et al [10], time needed for treatment had the most prominent predictive value for HRQoL. Age or gender were only minor predictors in this study.…”

“…In particular, moderate to severe psoriasis is frequently associated with serious comorbidity and significant loss of quality of life [2,3,4]. In addition, psoriatic care is far from being satisfactory: many treatments show low efficacy, have marked side effects or are time consuming [5,10], leading to a high burden of disease. Thus, modern psoriasis therapies should not only show good efficacy, but also have impact on patient-reported outcomes (PRO), i.e.…”

“…Also, studies of predictors of HRQoL are rare and have led to inconsistent results [10]. In one systematic review, it was shown that patients with more severe psoriasis and higher age had lower HRQoL [11].…”

Adherence in the Treatment of Psoriasis: A Systematic Review

“…Even if not all studies came to the same results, it is still clear that low efficacy, poor cosmetic properties (of topical therapy), a too time-consuming or burdensome treatment and the occurrence of side effects all have a negative effect on adherence [37,38,40,41]. It is remarkable that time needed for treatment was the major predictor of quality of life impairment in psoriasis [6]. …”

“…The incidence and disease burden of psoriasis result in a high need for care [6]. There is also a demand for the treatment of comorbidity, such as arthritis, depression, cardiovascular and metabolic diseases or chronic inflammatory auto-immune diseases [7,8,9,10].…”