INTRODUCTION
Topical treatments are often used both as initial monotherapy for more localized presentations of psoriasis and as adjunctive therapy for more severe disease.1-3 Topical medications focally target affected skin lesions, resulting in lower levels of systemic exposure and thus potentially fewer systemic adverse effects compared with systemic therapies.4 However, psoriasis is a complex and chronic disease, and symptoms, severity, and therapeutic needs may change over time. Thus, treatment is a lifelong challenge and concern. Over the course of their disease, it is common for patients with psoriasis to use multiple topical therapies.5 To effectively treat patients, clinicians must consider why previous treatments may have been inadequate and/or intolerable and recommend therapies that optimize therapeutic response for the individual patient.
Studies have suggested discordance between physician- and patient-reported treatment outcomes owing to misalignment of physician perceptions with patient preferences regarding treatment satisfaction.6,7 In a study of 80 individuals with psoriasis, correlation was weak between objective improvements in skin lesions (measured by psoriasis area and severity index) and patient-reported quality-of-life improvements (P=0.50).8 Greater concordance between physicians’ treatment recommendations and patient preferences may result in improved patient satisfaction. A commonly identified reason for patients to alter their therapeutic regimen is lack of effectiveness and symptom relief.5 Failure to achieve disease control that matches patient expectations may lead to poor adherence and decreased quality of life.6
Multiple factors influence patient satisfaction with treatment, including skin clearance, symptom relief, and ease of use. Occasionally, patients may be satisfied with less than a "clear" outcome if the treatment is easier to use or better tolerated.2 However, use of topical drugs may also be inconvenient and time-consuming;9 formulations that are messy and difficult
Studies have suggested discordance between physician- and patient-reported treatment outcomes owing to misalignment of physician perceptions with patient preferences regarding treatment satisfaction.6,7 In a study of 80 individuals with psoriasis, correlation was weak between objective improvements in skin lesions (measured by psoriasis area and severity index) and patient-reported quality-of-life improvements (P=0.50).8 Greater concordance between physicians’ treatment recommendations and patient preferences may result in improved patient satisfaction. A commonly identified reason for patients to alter their therapeutic regimen is lack of effectiveness and symptom relief.5 Failure to achieve disease control that matches patient expectations may lead to poor adherence and decreased quality of life.6
Multiple factors influence patient satisfaction with treatment, including skin clearance, symptom relief, and ease of use. Occasionally, patients may be satisfied with less than a "clear" outcome if the treatment is easier to use or better tolerated.2 However, use of topical drugs may also be inconvenient and time-consuming;9 formulations that are messy and difficult
