Conflict of interest
Identifying individual psychosocial and adherence support needs in patients with psoriasis: a multinational two-stage qualitative and quantitative study
Article first published online: 13 MAY 2013
© 2013 The Authors Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of the European Academy of Dermatology and Venereology.
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Journal of the European Academy of Dermatology and Venereology
Volume 28, Issue 6, pages 763–770, June 2014
How to Cite
Bewley, A., Burrage, D. M., Ersser, S. J., Hansen, M. and Ward, C. (2014), Identifying individual psychosocial and adherence support needs in patients with psoriasis: a multinational two-stage qualitative and quantitative study. Journal of the European Academy of Dermatology and Venereology, 28: 763–770. doi: 10.1111/jdv.12174
D. M. Burrage is a consultant for LEO Pharma. M Hansen is an employee of LEO Pharma. The other authors declare no conflicts of interest.
This study was supported by LEO Pharma.
- Issue published online: 10 MAY 2014
- Article first published online: 13 MAY 2013
- Manuscript Accepted: 2 APR 2013
- Manuscript Revised: 6 MAR 2013
- Manuscript Received: 17 DEC 2012
- LEO Pharma
Psoriasis 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.
We aimed to develop statements that could assist the consultation process, identifying the relative importance of factors related to effective management of psoriasis for patients.
A 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.
Fifty-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.
Questioning 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.