Patient Preferences in Topical Psoriasis Treatment
April 2023 | Volume 22 | Issue 4 | 326 | Copyright © April 2023
Published online March 18, 2023
Alyssa Curcio BAa, Christina Kontzias BAa, Brandon Gorodokin BAb, Steven R. Feldman MD PhDa,c,d, Leon H. Kircik MDe
aCenter for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC
bWeill Cornell Medical Center, New York, NY
cDepartment of Pathology, Wake Forest School of Medicine, Winston-Salem, NC
dDepartment of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, NC
eIcahn School of Medicine at Mount Sinai, New York, NY; Indiana University Medical Center, Indianapolis, IN;
Physicians Skin Care, PLLC Louisville, KY; DermResearch, PLLC Louisville, KY; Skin Sciences, PLLC Louisville, KY
Abstract
Background: Psoriasis is a common inflammatory skin condition that varies in severity. Most patients have limited disease amenable to topical treatment; however, poor treatment adherence limits efficacy. The purpose of this study was to assess patients’ psoriasis treatment experience, expectations, and preferences.
Method: The National Psoriasis Foundation conducted a 17-question survey in March 2022 assessing psoriasis severity, bothersome signs and symptoms, current treatment modalities, frequency of topical therapy use, and vehicle preferences. Statistical analysis of the qualitative data was performed using descriptive analysis and calculations of relative frequencies.
Results: Most participants self-reported moderate psoriasis (83.9%). The most common bothersome symptoms were scaly appearance (78.8%), bleeding/oozing (60%), itch (55%), and flaking (37.4%). For treatment, 72.5% of participants disclosed using oral medication, while 8% used topical treatment alone. Most participants (76%) reported using topical therapy at least once weekly. Nearly 80% of participants said they would allow 2 weeks for a medication to become effective before considering discontinuation. Participants preferred water-based creams (75.7%), followed by oil-based foam (70.8%), gel (48.7%), solution (42.8%), lotion (21.2%), non-oil-based foam (17.5%), ointment (16.5%), and spray (6.3%). The formulation attributes rated most important were application feel (55.2%), non-staining (49.9%), quick absorption (46.7%), non-sticky texture (39.7%), ease of application (28.5%), no unpleasant smell (22.4%), non-greasy (16.8%), works quickly (14.1%), absent sting or burn (10%), no adverse skin reaction (9.7%), and once daily treatment (6.8%). If participants did not like a topical treatment's formulation, most (74.7%) said they would continue to use the medication for a week before discontinuation.
Conclusion: Topical treatments continue to be a mainstay of psoriasis treatment. Patients expect to see rapid improvement with topical treatment; otherwise, they report that they will discontinue treatment. The characteristics of psoriasis treatment vehicles also affect patients’ reported willingness to use treatment and may be an important consideration in treatment planning.
J Drugs Dermatol. 2023;22(4): doi:10.36849/JDD.7372
Citation: Curcio A, Kontzias C, Gorodokin B, et al. Patient preferences in topical psoriasis treatment.
J Drugs Dermatol. 2023;22(4):326-329. doi:10.36849/JDD.7372
INTRODUCTION
Psoriasis is a chronic immune-mediated inflammatory disease affecting the skin. First-line treatment for mild-to-moderate psoriasis is topical treatment, including corticosteroids, vitamin D analogs, keratinolytics, calcineurin inhibitors, salicylic acid, and tar.1,2 For moderate-to-severe psoriasis, the American Academy of Dermatology recommends considering systemic therapy, including biologics, oral agents, and phototherapy, with the option to use topical medication conjunctively.3
Though topical therapy is effective, there is often suboptimal use of topical medications. Medication adherence is affected by numerous factors, including efficacy, cost, and the complexity of treatment, among others.4-7 The character of a product’s formulation, ease of use, duration of application, and overall convenience may affect patients’ preferences and use.8
Patient’s expectations of topical treatment are not well characterized, and there is little information on their preferences for new types of vehicles. In this study, we assessed participants’ psoriasis treatment experience, expectations, and preferences.
MATERIALS AND METHODS
A National Psoriasis Foundation (NPF) survey conducted in March 2022 recruited 411 participants to complete 16 multiple choice questions and one short answer question (Table 1).
