Skip to main content
SpringerLink
Log in

Adherence in Psoriasis

  • Chapter
  • First Online:
Treatment Adherence in Dermatology

Part of the book series: Updates in Clinical Dermatology ((UCD))

Abstract

Psoriasis is a chronic skin disease with a major effect on quality of life. Treatment can be complex and may include topical corticosteroids, topical steroid-sparing agent, phototherapy, and oral therapy with systemic agents, or treatment with biologics. Biologics have higher adherence compared to other treatment modalities in psoriasis. However, such complexity of treatment contributes to the high rates of nonadherence in psoriasis patients. Other barriers to adherence include fear of side effects, knowledge gaps, forgetfulness, and high medication cost. Recognizing the prevalence of nonadherence and its impact on suboptimal treatment outcomes is crucial. Focusing on patient education, implementing a reminder system, and improving accountability are some of the approaches to improve adherence. Improving adherence will certainly lead to better treatment outcomes, reduced suffering, and better quality of life.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 54.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Ventura A, Mazzeo M, Gaziano R, Galluzzo M, Bianchi L, Campione E. New insight into the pathogenesis of nail psoriasis and overview of treatment strategies. Drug Des Devel Ther. 2017;11:2527–35.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Armstrong AW, Schupp C, Wu J, Bebo B. Quality of life and work productivity impairment among psoriasis patients: findings from the National Psoriasis Foundation survey data 2003–2011. PLoS One. 2012;7(12):e52935.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Ryan C, Kirby B. Psoriasis is a systemic disease with multiple cardiovascular and metabolic comorbidities. Dermatol Clin. 2015;33:41–55.

    Article  CAS  PubMed  Google Scholar 

  4. Brezinski EA, Dhillon JS, Armstrong AW. Economic burden of psoriasis in the United States: a systematic review. JAMA Dermatol. 2015;151(6):651–8.

    Article  PubMed  Google Scholar 

  5. Richards HL, Fortune DG, Griffiths CE. Adherence to treatment in patients with psoriasis. J Eur Acad Dermatol Venereol. 2006;20(4):370–9.

    Article  CAS  PubMed  Google Scholar 

  6. Thorneloe RJ, Bundy C, Griffiths CE, Ashcroft DM, Cordingley L. Adherence to medication in patients with psoriasis: a systematic literature review. Br J Dermatol. 2013;168(1):20–31.

    Article  CAS  PubMed  Google Scholar 

  7. Carroll CL, Feldman SR, Camacho FT, Balkrishnan R. Better medication adherence results in greater improvement in severity of psoriasis. Br J Dermatol. 2004;151(4):895–7.

    Article  CAS  PubMed  Google Scholar 

  8. Augustin M, Holland B, Dartsch D, Langenbruch A, Radtke MA. Adherence in the treatment of psoriasis: a systematic review. Dermatology. 2011;222(4):363–74.

    Article  CAS  PubMed  Google Scholar 

  9. Storm A, Andersen SE, Benfeldt E, Serup J. One in 3 prescriptions are never redeemed: primary non-adherence in an outpatient clinic. J Am Acad Dermatol. 2008;59(1):27–33.

    Article  PubMed  Google Scholar 

  10. Zaghloul SS, Goodfield MJ. Objective assessment of compliance with psoriasis treatment. Arch Dermatol. 2004;140(4):408–14.

    Article  PubMed  Google Scholar 

  11. Balkrishnan R, Carroll CL, Camacho FT, Feldman SR. Electronic monitoring of medication adherence in skin disease: results of a pilot study. J Am Acad Dermatol. 2003;49(4):651–4.

    Article  PubMed  Google Scholar 

  12. Chan SA, Hussain F, Lawson LG, Ormerod AD. Factors affecting adherence to treatment of psoriasis: comparing biologic therapy to other modalities. J Dermatolog Treat. 2013;24(1):64–9.

    Article  CAS  PubMed  Google Scholar 

  13. Kivelevitch DN, Tahhan PV, Bourren P, et al. Self-medication and adherence to treatment in psoriasis. Int J Dermatol. 2012;51(4):416–9.

    Article  PubMed  Google Scholar 

  14. Devaux S, Castela A, Archier E, et al. Adherence to topical treatment in psoriasis: a systematic literature review. J Eur Acad Dermatol Venereol. 2012;26(Suppl 3):61–7.

    Article  PubMed  Google Scholar 

  15. Carroll CL, Feldman SR, Camacho FT, et al. Adherence to topical therapy decreases during the course of an 8-week psoriasis clinical trial: commonly used methods of measuring adherence to topical therapy overestimate actual use. J Am Acad Dermatol. 2004;51(2):212–6.

    Article  PubMed  Google Scholar 

  16. Alinia H, Moradi Tuchayi S, Smith JA, et al. Long-term adherence to topical psoriasis treatment can be abysmal: a 1-year randomized intervention study using objective electronic adherence monitoring. Br J Dermatol. 2017;176(3):759–64.

    Article  CAS  PubMed  Google Scholar 

  17. Fouere S, Adjadj L, Pawin H. How patients experience psoriasis: results from a European survey. J Eur Acad Dermatol Venereol. 2005;19(Suppl 3):2–6.

    Article  PubMed  Google Scholar 

  18. Lee IA, Maibach HI. Pharmionics in dermatology: a review of topical medication adherence. Am J Clin Dermatol. 2006;7:231–6.

    Article  PubMed  Google Scholar 

  19. Gokdemir G, Ari S, Koslu A. Adherence to treatment in patients with psoriasis vulgaris: Turkish experience. J Eur Acad Dermatol Venereol. 2008;22:330–5.

    Article  CAS  PubMed  Google Scholar 

  20. Choi JW, Kim BR, Youn SW. Adherence to topical therapies for the treatment of psoriasis: surveys of physicians and patients. Ann Dermatol. 2017;29(5):559–64.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Feldman SR. Disease burden and treatment adherence in psoriasis patients. Cutis. 2013;92(5):258–63.

    PubMed  Google Scholar 

  22. Brown KK, Rehmus WE, Kimball AB. Determining the relative importance of patient motivations for non-adherence to topical corticosteroid therapy in psoriasis. J Am Acad Dermatol. 2006;55(4):607–13.

    Article  PubMed  Google Scholar 

  23. Feldman SR, Horn EJ, Balkrishnan R, et al. Psoriasis: improving adherence to topical. J Am Acad Dermatol. 2008;59(6):1009–16.

    Article  PubMed  Google Scholar 

  24. Bewley A, Page B. Maximizing patient adherence for optimal outcomes in psoriasis. J Eur Acad Dermatol Venereol. 2011;25(Suppl 4):9–14.

    Article  PubMed  Google Scholar 

  25. Reisfeld PL. How high is up? Generic prices rise. Cutis. 2014;93(1):6–8.

    PubMed  Google Scholar 

  26. Ortonne JP, Humbert P, Nicolas JF, et al. Intra-individual comparison of the cutaneous safety and efficacy of calcitriol 3 microg g(−1) ointment and calcipotriol 50 microg g(−1) ointment on chronic plaque psoriasis localized in facial, hairline, retroauricular or flexural areas. Br J Dermatol. 2003;148(2):326–33.

    Article  CAS  PubMed  Google Scholar 

  27. Zschocke I, Mrowietz U, Karakasili E, Reich K. Non-adherence and measures to improve adherence in the topical treatment of psoriasis. J Eur Acad Dermatol Venereol. 2014;28 Suppl 2:4–9.

    Article  CAS  PubMed  Google Scholar 

  28. Kontochristopoulos G, Kouris A, Chantzaras A, et al. Improvement of health-related quality of life and adherence to treatment with calcipotriol-betamethasone dipropionate gel in patients with psoriasis vulgaris. An Bras Dermatol. 2016;91(2):160–6.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Lebwohl M, Freeman AK, Chapman MS, et al. Tacrolimus ointment is effective for facial and intertriginous psoriasis. J Am Acad Dermatol. 2004;51(5):723–30.

    Article  PubMed  Google Scholar 

  30. Siegfried EC, Jaworski JC, Hebert AA. Topical calcineurin inhibitors and lymphoma risk: evidence update with implications for daily practice. Am J Clin Dermatol. 2013;14(3):163–78.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Weinstein GD, Koo JY, Krueger GG, et al. Tazarotene cream in the treatment of psoriasis: Two multicenter, double-blind, randomized, vehicle-controlled studies of the safety and efficacy of tazarotene creams 0.05% and 0.1% applied once daily for 12 weeks. J Am Acad Dermatol. 2003;48(5):760–7.

    Article  PubMed  Google Scholar 

  32. Gollnick H, Menter A. Combination therapy with tazarotene plus a topical corticosteroid for the treatment of plaque psoriasis. Br J Dermatol. 1999;140(Suppl 54):18–23.

    Article  CAS  PubMed  Google Scholar 

  33. Blakely K, Gooderham M. Management of scalp psoriasis: current perspectives. Psoriasis (Auckl). 2016;6:33–40.

    CAS  PubMed  PubMed Central  Google Scholar 

  34. Dommasch ED, Lee MP, Joyce CJ, Garry EM, Gagne JJ. Drug utilization patterns and adherence in patients on systemic medications for the treatment of psoriasis: a retrospective, comparative cohort study. J Am Acad Dermatol. 2018;79(6):1061–1068.e1.

    Article  PubMed  Google Scholar 

  35. Arnold T, Schaarschmidt ML, Herr R, et al. Drug survival rates and reasons for drug discontinuation in psoriasis. J Dtsch Dermatol Ges. 2016;14(11):1089–99.

    Article  PubMed  Google Scholar 

  36. Bhosle MK, Feldman SR, et al. Medication adherence and health care costs associated with biologics in Medicaid-enrolled patients with psoriasis. J Dermatolog Treat. 2006;17(5):294–301.

    Article  PubMed  Google Scholar 

  37. Hsu DY, Gniadecki R. Patient adherence to biologic agents in psoriasis. Dermatology. 2016;232(3):326–33.

    Article  CAS  PubMed  Google Scholar 

  38. Esposito M, Gisondi P, Cassano N, et al. Survival rate of antitumour necrosis factor-alpha treatments for psoriasis in routine dermatological practice: a multicentre observational study. Br J Dermatol. 2013;169(3):666–72.

    Article  CAS  PubMed  Google Scholar 

  39. Doshi JA, Takeshita J, Pinto L, et al. Biologic therapy adherence, discontinuation, switching, and restarting among patients with psoriasis in the US Medicare population. J Am Acad Dermatol. 2016;74(6):1057–1065.e4.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Ross C, Marshman G, Grillo M, Stanford T. Biological therapies for psoriasis: adherence and outcome analysis from a clinical perspective. Australas J Dermatol. 2016;57(2):137–40.

    Article  PubMed  Google Scholar 

  41. Strober MDPBE. Methotrexate and cyclosporine in psoriasis revisited. Semin Cutan Med Surg. 2014;33(2S):S27–30.

    Article  PubMed  Google Scholar 

  42. Gisondi P, Tessari G, Di Mercurio M, et al. Retention rate of systemic drugs in patients with chronic plaque psoriasis. Clin Dermatol. 2013;1(1):8–14.

    Google Scholar 

  43. Vidal D, Salleras M, Romani J, et al. Adherence of self-administered subcutaneous methotrexate in patients with chronic plaque-type psoriasis. J Eur Acad Dermatol Venereol. 2016;30(11):e131–2.

    CAS  PubMed  Google Scholar 

  44. Dogra S, Yadav S. Acitretin in psoriasis: an evolving scenario. Int J Dermatol. 2014;53(5):525–38.

    Article  PubMed  Google Scholar 

  45. Shalom G, Cohen AD, Ziv M, et al. Biologic drug survival in Israeli psoriasis patients. J Am Acad Dermatol. 2017;76(4):662–669.e1.

    Article  CAS  PubMed  Google Scholar 

  46. Zhang P, Wu MX. A clinical review of phototherapy for psoriasis. Lasers Med Sci. 2018;33(1):173–80.

    Article  CAS  PubMed  Google Scholar 

  47. Racz E, Prens EP. Phototherapy of psoriasis, a chronic inflammatory skin disease. Adv Exp Med Biol. 2017;996:287–94.

    Article  CAS  PubMed  Google Scholar 

  48. Lynde CW, Gupta AK, Guenther L, Poulin Y, Levesque A, Bissonnette R. A randomized study comparing the combination of nbUVB and etanercept to etanercept monotherapy in patients with psoriasis who do not exhibit an excellent response after 12 weeks of etanercept. J Dermatolog Treat. 2012;23(4):261–7.

    Article  CAS  PubMed  Google Scholar 

  49. Nolan BV, Yentzer BA, Feldman SR. A review of home phototherapy for psoriasis. Dermatol Online J. 2010;16(2):1.

    PubMed  Google Scholar 

  50. Thorneloe RJ, Bundy C, Griffiths CE, Ashcroft DM, Cordingley L. Nonadherence to psoriasis medication as an outcome of limited coping resources and conflicting goals: findings from a qualitative interview study with people with psoriasis. Br J Dermatol. 2017;176(3):667–76.

    Article  CAS  PubMed  Google Scholar 

  51. Feldman SR, Vrijens B, Gieler U, et al. Treatment adherence intervention studies in dermatology and guidance on how to support adherence. Am J Clin Dermatol. 2017;18(2):253–71.

    Article  PubMed  Google Scholar 

  52. Yelamos O, Ros S, Puig L. Improving patient outcomes in psoriasis: strategies to ensure treatment adherence. Psoriasis (Auckl). 2015;5:109–15.

    CAS  Google Scholar 

  53. Bewley A, Burrage DM, Ersser SJ, et al. Identifying individual psychosocial and adherence support needs in patients with psoriasis: a multinational two-stage qualitative and quantitative study. J Eur Acad Dermatol Venereol. 2014;28:763–70.

    Article  CAS  PubMed  Google Scholar 

  54. Ersser SJ, Cowdell FC, Latter SM, Healy E. Self-management experiences in adults with mild-moderate psoriasis: an exploratory study and implications for improved support. Br J Dermatol. 2010;163:1044–9.

    Article  CAS  PubMed  Google Scholar 

  55. D'Souza LS, Payette MJ. Estimated cost efficacy of systemic treatments that are approved by the US Food and Drug Administration for the treatment of moderate to severe psoriasis. J Am Acad Dermatol. 2015;72(4):589–98.

    Article  PubMed  Google Scholar 

  56. Lebwohl MG, Bachelez H, Barker J, et al. Patient perspectives in the management of psoriasis: results from the population-based Multionational Assessment of Psoriasis and Psoriatic Arthritis Survey. J Am Acad Dermatol. 2014;70(5):871–81.

    Article  PubMed  Google Scholar 

  57. Ros S, Puig L, Carrascosa JM. Cumulative life course impairment: the imprint of psoriasis on the patient’s life. Actas Dermosifiliogr. 2014;105(2):128–34.

    Article  CAS  PubMed  Google Scholar 

  58. Aslam I, Feldman SR. Practical strategies to improve patient adherence to treatment regimens. South Med J. 2015;108:325–31.

    PubMed  Google Scholar 

  59. Pouplard C, Gourraud PA, Meyer N, et al. Are we giving patients enough information on how to use topical treatments? Analysis of 767 prescriptions in psoriasis. Br J Dermatol. 2011;165:1332–6.

    Article  CAS  PubMed  Google Scholar 

  60. Martin SL, McGoey ST, Bebo BF Jr, Feldman SR. Patients' educational needs about topical treatments for psoriasis. J Am Acad Dermatol. 2013;68(6):e163–8.

    Article  PubMed  Google Scholar 

  61. Feldman SR. Approaching psoriasis differently: patient-physician relationships, patient education and choosing the right topical vehicle. J Drugs Dermatol. 2010;9:908–11.

    PubMed  Google Scholar 

  62. Zirwas MJ, Holder JL. Patient education strategies in dermatology: Part 2: methods. J Clin Aesthet Dermatol. 2009;2:28–34.

    PubMed  PubMed Central  Google Scholar 

  63. Reich K, Zschocke I, Bachelez H, et al. A Topical Treatment Optimization Programme (TTOP) improves clinical outcome for calcipotriol/betamethasone gel in psoriasis: results of a 64-week multinational randomized phase IV study in 1790 patients (PSO-TOP). Br J Dermatol. 2017;177(1):197–205.

    Article  CAS  PubMed  Google Scholar 

  64. Caldarola G, De Simone C, Moretta G, Poscia A, Peris K. Role of personalized medication training in improving efficacy and adherence to a topical therapy in psoriatic patients. J Dermatolog Treat. 2017;28(8):722–5.

    Article  CAS  PubMed  Google Scholar 

  65. Bonnekoh B, Schmid-Ott G, Herold S, Sayegh-Jodehl S, Dierkes J, et al. Interdisciplinary training program for adults with psoriasis: six months follow-up. Hautarzt. 2006;57(10):917–22.

    Article  CAS  PubMed  Google Scholar 

  66. Wang W, Qiu Y, Zhao F, Zhang F. Poor medication adherence in patients with psoriasis and a successful intervention. J Dermatolog Treat. 2018;23:1–18.

    Google Scholar 

  67. Fenerty SD, West C, Davis SA, Kaplan SG, Feldman SR. The effect of reminder systems on patients’ adherence to treatment. Patient Prefer Adherence. 2012;6:127–35.

    PubMed  PubMed Central  Google Scholar 

  68. Alpalhão M, Antunes J, Gouveia A, et al. A randomized controlled clinical trial to assess the impact of motivational phone calls on therapeutic adherence in patients suffering from psoriasis. Dermatol Ther. 2018;31(5):e12667.

    Article  PubMed  Google Scholar 

  69. Balato N, Megna M, Di Costanzo L, Balato A, Ayala F. Educational and motivational support service: a pilot study for mobile-phone-based interventions in patients with psoriasis. Br J Dermatol. 2013;168(1):201–5.

    Article  CAS  PubMed  Google Scholar 

  70. Svendsen MT, Andersen F, Andersen KH, et al. A smartphone application supporting patients with psoriasis improves adherence to topical treatment: a randomized controlled trial. Br J Dermatol. 2018;179(5):1062–71.

    Article  CAS  PubMed  Google Scholar 

  71. Umar N, Litaker D, Schaarschmidt ML, et al. Outcomes associated with matching patients’ treatment preferences to physicians’ recommendations: study methodology. BMC Health Serv Res. 2012;12:1–12.

    Article  PubMed  PubMed Central  Google Scholar 

  72. Uhlenhake EE, Kurkowski D, Feldman SR. Conversations on psoriasis – what patients want and what physicians can provide: a qualitative look at patients and physician expectations. J Dermatolog Treat. 2010;21(1):6–12.

    Article  PubMed  Google Scholar 

  73. Zalewska A, Miniszewska J, Chodkiewicz J, Narbutt J. Acceptance of chronic illness in psoriasis vulgaris patients. J Eur Acad Dermatol Venereol. 2007;21(2):235–42.

    Article  CAS  PubMed  Google Scholar 

  74. Kulkarni AS, Balkrishnan R, Camacho FT, et al. Medication and health care service utilization related to depressive symptoms in older adults with psoriasis. J Drugs Dermatol. 2004;3:661–6.

    PubMed  Google Scholar 

  75. Yentzer BA, Yelverton CB, Pearce DJ, Camacho FT, Makhzoumi Z, Clark A, et al. Adherence to acitretin and home narrowband ultraviolet B phototherapy in patients with psoriasis. J Am Acad Dermatol. 2008;59(4):577–81.

    Article  PubMed  Google Scholar 

  76. Koek MB, Buskens E, van Weelden H, Steegmans PH, Bruijnzeel-Koomen CA, Sigurdsson V. Home versus outpatient ultraviolet B phototherapy for mild to severe psoriasis: pragmatic multicentre randomised controlled non-inferiority trial (PLUTO study). BMJ. 2009;338:b1542.

    Article  PubMed  PubMed Central  Google Scholar 

  77. Koek MB, Sigurdsson V, van Weelden H, Steegmans PH, Bruijnzeel-Koomen CA, Buskens E. Cost effectiveness of home ultraviolet B phototherapy for psoriasis: economic evaluation of a randomised controlled trial (PLUTO study). BMJ. 2010;340:c1490.

    Article  PubMed  PubMed Central  Google Scholar 

  78. Cline A, Unrue EL, Collins A, Feldman SR. Adherence to a novel home phototherapy system with integrated features. Dermatol Online J. 2019;25(3):3.

    Google Scholar 

Download references

Disclosures

Feldman has received research, speaking and/or consulting support from a variety of companies including Galderma, GSK/Stiefel, Almirall, Leo Pharma, Boehringer Ingelheim, Mylan, Celgene, Pfizer, Valeant, Abbvie, Samsung, Janssen, Lilly, Menlo, Merck, Novartis, Regeneron, Sanofi, Novan, Qurient, National Biological Corporation, Caremark, Advance Medical, Sun Pharma, Suncare Research, Informa, UpToDate and National Psoriasis Foundation. He is founder and majority owner of www.DrScore.com and founder and part owner of Causa Research, a company dedicated to enhancing patients’ adherence to treatment..

Wasim Haidari, Eugenie Quan, and Dr. Cline have no conflicts to disclose.

Author information

Authors and Affiliations

  1. Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA

    Wasim Haidari & Eugenie Y. Quan

  2. Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA

    Abigail Cline

  3. Departments of Dermatology, Pathology and Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA

    Steven R. Feldman

Authors
  1. Wasim Haidari
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eugenie Y. Quan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Abigail Cline
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Steven R. Feldman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Wasim Haidari .

Editor information

Editors and Affiliations

  1. Departments of Dermatology, Pathology and Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA

    Steven R. Feldman

  2. Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA

    Abigail Cline

  3. Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA

    Adrian Pona

  4. Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA

    Sree S. Kolli

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Haidari, W., Quan, E.Y., Cline, A., Feldman, S.R. (2020). Adherence in Psoriasis. In: Feldman, S., Cline, A., Pona, A., Kolli, S. (eds) Treatment Adherence in Dermatology. Updates in Clinical Dermatology. Springer, Cham. https://doi.org/10.1007/978-3-030-27809-0_7

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-27809-0_7

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-27808-3

  • Online ISBN: 978-3-030-27809-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation