American Journal of Clinical Dermatology

, Volume 18, Issue 4, pp 571–581 | Cite as

Development and Validation of a Novel Questionnaire for Adherence with Topical Treatments in Psoriasis (QATOP)

  • Ana Teixeira
  • Carolina Oliveira
  • Maribel Teixeira
  • A. Rita Gaio
  • José Manuel Sousa Lobo
  • Isabel Filipa Martins de Almeida
  • Vera Almeida
Original Research Article



Self-report measures are the most used methodologies for the evaluation of adherence to psoriasis topical treatment, although currently there is no standard questionnaire for this purpose.


The present study aimed at developing a novel questionnaire (Questionnaire for Adherence to TOPical treatment [QATOP]) for the assessment of adherence to topical treatment in psoriasis.


A questionnaire containing nine items organized into two parts (part 1: current patient treatment; part 2: adherence to treatment, amount used, and treatment-associated variables) was developed, supported by a systematic literature review, qualitative patient focus interviews, and expert-group input. Its content validity was determined by a pilot study of six patients. Adherence to topical treatment was then assessed in 35 patients with psoriasis, after 45 days of treatment, using the QATOP and a medication log. Associations between different items of the QATOP and the log were investigated.


Adherence results were 63.5 ± 29.2% for the log and 60.9 ± 24.4% for the QATOP, and were strongly correlated (R = 0.819, p < 0.001). Distinct posologic regimens were reported by patients, which, in some cases, were not the usual doses. Patients also reported using doses of medicine on each application that were markedly lower than required.


The QATOP is a valid and reliable self-report measure of adherence to topical treatment in patients with psoriasis. The use of this standard questionnaire could improve the methodological quality of adherence studies. Improvement of the clarity of posologic instructions is clearly urgently needed.


Psoriasis Topical Treatment Psoriasis Patient Calcipotriol Tazarotene 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors would like to thank all patients who participated in this study, the Portuguese Association of Psoriasis (PSOPortugal) for assistance with data collection, and CESPU—Cooperativa de Ensino Superior Politécnico e Universitário for financial support of this study (projects 04-GCQF-CICS-2011N and POSOL-DERM-CESPU-2016). A. Rita Gaio was partially supported by CMUP—Centro de Matemática da Universidade do Porto (UID/MAT/00144/2013), which is funded by FCT—Fundação para a Ciência e a Tecnologia (Portugal) with national (MEC—Ministério da Educação e Ciência) and European structural funds through the FEDER—Fundo Europeu de Desenvolvimento Regional program, under partnership Agreement PT2020.

Compliance with Ethical Standards

Conflict of interest

Ana Teixeira, Carolina Oliveira, Maribel Teixeira, A. Rita Gaio, José Manuel Sousa Lobo, Isabel Filipa Almeida and Vera Almeida have no conflicts of interest to declare.


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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  • Ana Teixeira
    • 1
    • 2
  • Carolina Oliveira
    • 1
  • Maribel Teixeira
    • 1
  • A. Rita Gaio
    • 3
  • José Manuel Sousa Lobo
    • 2
  • Isabel Filipa Martins de Almeida
    • 2
  • Vera Almeida
    • 1
    • 2
  1. 1.CESPU, Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde (IINFACTS)Instituto Universitário de Ciências da Saúde4585-116 Gandra PRDPortugal
  2. 2.UCIBIO, REQUIMTE, Laboratório de Tecnologia Farmacêutica, Faculdade de FarmáciaUniversidade do PortoPortoPortugal
  3. 3.Departamento de MatemáticaFaculdade de Ciências da Universidade do Porto e Centro de Matemática da Universidade do PortoPortoPortugal

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