PowerPoint Presentation Wake Forest University School of Medicine is the academic core of Atrium Health. INTRODUCTION • 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 efficacy1,2,3 • Purpose: To assess patients’ psoriasis treatment experience, expectations, and preferences METHODS • The National Psoriasis Foundation conducted a survey in March 2022 that recruited 411 participants • Inclusion criteria: o Psoriasis diagnosed by a healthcare provider o Active disease within six months to one year of the survey collection o Commercial insurance Alyssa Curcio1, Christina Kontzias1 Steven R. Feldman1 1 Wake Forest School of Medicine, Department of Dermatology Improving Patient Acceptability and Adherence in Psoriasis Treatment RESULTS • Most participants (83.9%) self-reported moderate psoriasis • Symptoms reported the most bothersome were scaly appearance (78.8%), bleeding/oozing (60%), itch (55%), and flaking (37.4%) • Most participants (76%) reported using topical therapy at least once weekly • Nearly 80% of participants said they would allow two weeks for a medication to become effective before considering discontinuation • If a topical medication caused a reaction, more than 40% of patients said they would call another dermatologist • 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 they will discontinue treatment • The characteristics of psoriasis treatment vehicles also affects patients’ reported willingness to use treatment and may be an important consideration in treatment planning REFRENCES 1. Savary J, Ortonne JP, Aractingi S. The right dose in the right place: an overview of current prescription, instruction and application modalities for topical psoriasis treatments. J Eur Acad Dermatol Venereol. 2005 Nov;19 Suppl 3:14-7. doi: 10.1111/j.1468 3083.2005.01333.x. PMID: 16274407. 2. Feldman SR, Horn EJ, Balkrishnan R, Basra MK, Finlay AY, McCoy D, Menter A, van de Kerkhof PC; International Psoriasis Council. Psoriasis: improving adherence to topical therapy. J Am Acad Dermatol. 2008 Dec;59(6):1009-16. doi: 10.1016/j.jaad.2008.08.028. Epub 2008 Oct 2. PMID: 18835062. 3. Florek AG, Wang CJ, Armstrong AW. Treatment preferences and treatment satisfaction among psoriasis patients: a systematic review. Arch Dermatol Res. 2018 May;310(4):271-319. doi: 10.1007/s00403-018-1808-x. Epub 2018 Feb 13. PMID:29442137. National Psoriasis Foundation Survey Questions 1. How would you describe your psoriasis? 2. How has your dermatologist categorized your psoriasis? 3. Where do you have/had psoriasis plaques? 4. How frequently do you use topical prescriptions to treat your psoriasis plaques? 5. Do you use prescription, over-the-counter medication, or both to treat your psoriasis? 6. Other than topical medications, what other prescription-based treatment do you routinely use? 7. How quickly do you need to notice an improvement in your psoriasis due to a topical prescription medication before you assume it isn’t working and stop usings it? 8. Which signs and symptom(s) of your psoriasis do you find most bothersome? 9. Do you suffer from itch due to your psoriasis? 10. If you have itch, where does this affect you? 11. On a scale of 1-10, how would you rate the worst your itch has been in the last month? 12. Which attributes are most important to you in a prescription treatment? 13. If you don’t like the product formulation prescribed, how long will you give it to see if it works? 14. If a topical prescription your dermatologist prescribed for you causes an unpleasant reaction or rash on your skin, what are you most likely to do? 15. Of all the topical prescription treatments you’ve previously tried, which three formulations have you preferred? 16. If you have used a topical prescription treatment on your scalp, how easy was it to remove the medication from your hair? 17. If you can remember the brand names of any topical prescription products you’ve used, please list them. 227 205 192 163 117 92 69 58 41 40 28 Application feel Doesn’t stain fabric Quick absorbtion Not sticky/thick Application ease No unpleasant smell Non-greasy Works quickly Doesn’t sting or burn No adverse skin reaction Once daily treatment Number of Survery Participants Topical Treatment Formulation Preferences 75.7% 70.8% 48.7% 42.8% 31.2% 17.5% 16.5% 6.3% P e rc e n ta g e o f P S u rv e y P a rt ic ip a n ts Topical Treatment Vehicle Preferences