Discordance Between Patient Reported Motivations to Seek Treatment for Psoriasis Compared to Television Advertisements
August 2018 | Volume 17 | Issue 8 | Original Article | 886 | Copyright © 2018
Nicole M. Golbari BA,a Martina L. Porter MD,b Alexa B. Kimball MD MPHc
aStony Brook University School of Medicine, Stony Brook, NY bHarvard Medical School, Clinical Laboratory for Epidemiology and Applied Research in Skin (CLEARS), Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, MA
Introduction: Despite a growing arsenal of therapies for psoriasis and, consequently, an increasing number of advertisements for these treatments, many psoriasis patients still remain untreated. While the primary treatment seeking motivations for these patients have been identified, it is unknown if the commercials for the medications designed to encourage patient engagement in treatment are relevant to these concerns. Methods: Online databases for national television advertisements were searched for psoriasis treatment commercials broadcast between 2000 and 2018. Each advertisement video was viewed 3 times and separately assessed for the content displayed or information conveyed in images, text, and voice-over speech. Additionally, references to known patient motivations for seeking treatment, including concerns about skin symptoms or appearance (embarrassment, scaling/flaking, pain, discomfort, itch, etc.) were recorded. Results: A total of 20 commercials were assessed. Of those, 100% emphasized “clear skin” as the result of the treatment that was being marketed. Bothersome skin symptoms, however, were less frequently displayed; scaling/flaking, pain/discomfort, and itch were present in 15%, 5%, and 0% of commercials, respectively. Similarly, text or images displaying sadness, shame or covering of skin were in 40%, 45% and 30% the advertisements, respectively. None (0%) of the commercials evaluated displayed images of people scratching or verbally addressed skin itching as a bothersome symptom of psoriasis. Conclusions and Relevance: While the advertisements assessed in this study did exhibit patient concerns regarding skin appearance, skin symptoms including skin itching, flaking, pain and discomfort were not equally addressed. As these are known factors that motivate psoriasis patients to actively engage in treatment, targeted ads that better demonstrate these concerns may help prompt under-treated patients to seek care. J Drugs Dermatol. 2018;17(8):886-887.
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Pharmaceutical companies spend billions of dollars yearly advertising medications. Spending on direct to consumer advertisements for psoriasis agents in particular has increased considerably over the last several year. Four of the top twenty drugs with highest television advertisement spending in 2017 were medications approved for psoriasis and psoriatic arthritis 1; however, the impact of advertisements on patient behavior modification is unclear.2In a previous study, we demonstrated that psoriasis patients seek care due to embarrassment about appearance and debilitation secondary to psoriasis symptoms, including pain, skin itching, flaking, and inflammation.3,4 Conversely, advertisements for medications had the least influence on patients’ decision to seek care compared to other factors.4 Given this information, we sought to evaluate advertisements targeted at psoriasis patients to determine if commercials address these known patient concerns.
YouTube and iSpot.tv, a database for television advertisements, were searched for “psoriasis medication commercials/advertisements” broadcast between 2000-2018. Twenty commercials at least 30 seconds(s) in length were identified (median, 60s; mean, 53.84s); 19 were advertisements for biologic agents and 1 advertisement was for laser therapy. The commercials were viewed 3 times each, and assessed for the information conveyed in images, text, and voice-over speech.
All of the commercials included adult protagonists (100%), and the majority included people of both genders (65%), and different races (55%). Other central figures included the elderly (35%), actual patients (20%), celebrity spokespeople (15%), and physicians (5%). Commercials displayed imagery related to physical contact with others (75%), romantic relationships (60%), travel/vacation (50%), and professional or business settings (35%). Almost all of the advertisements discussed or displayed efficacy results from clinical studies (85%), but only one commercial (5%) discussed the mechanism of the medication