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Patient-relevant treatment goals in psoriasis

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Abstract

Patient-oriented care requires therapeutic decisions to agree with the patients’ treatment needs and goals. This study addressed the following questions: What is important to psoriasis patients starting systemic treatment? How stable are these preferences within the first year of treatment? Are treatment goals associated with age, gender, or treatment success? The importance of treatment goals was assessed for patients with moderate-to-severe psoriasis in the German Psoriasis Registry (PsoBest) at baseline (onset of a systemic treatment; n = 3066) and at a 1-year follow-up (n = 1444) using the Patient Benefit Index (PBI). Treatment success was measured with PBI global score and Psoriasis Area Severity Index (PASI). Patients with moderate-to-severe psoriasis pursued a wide range of different goals. The most general treatment goals were rated most relevant, including skin healing and quick skin improvement (94.8/94.5 % “quite” or “very” important), confidence in the therapy (93.0 %), control over the disease (92.3 %), and a clear diagnosis and therapy (89.6 %). Further important goals related to not being in fear of the disease getting worse (84.8 %), reduction in itching (83.9 %), burning (70.6 %), and pain (60.6 %) as well as attaining a normal everyday life (78.4 %) and low treatment burden (64.2–77.9 %). Goals were mostly not associated with sex and gender. Goal importance slightly increased with treatment success. In a substantial proportion of patients (30.3–54.7 %) goal importance changed within 1 year after onset of systemic treatment. We conclude that treatment goal importance should be assessed in clinical practice on a regular basis.

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Authors and Affiliations

  1. German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany

    Christine Blome, Ramona Gosau, Marc A. Radtke, Stephan J. Rustenbach, Christina Spehr & Matthias Augustin

  2. Dermatologikum Hamburg, Hamburg, Germany

    Kristian Reich

  3. Comprehensive Center for Inflammation Medicine, University of Lübeck, Lübeck, Germany

    Diamant Thaçi

Authors
  1. Christine Blome
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  2. Ramona Gosau
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  3. Marc A. Radtke
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  4. Kristian Reich
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  5. Stephan J. Rustenbach
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  6. Christina Spehr
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  7. Diamant Thaçi
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  8. Matthias Augustin
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Corresponding author

Correspondence to Christine Blome.

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Funding

The study was supported by the German Federal Ministry of Education and Research (BMBF) within the context of the Hamburg Centre for Health Economics (HCHE), Grant No. 01EH1101B. The German Psoriasis Registry PsoBest is commissioned by the Professional Society of German Dermatologists (BVDD) and the German Society of Dermatology (DDG). It is also funded by changing pharmaceutic companies.

Conflict of interest

Blome C has received speaker honoraria, research grants, awards, and/or travel grants from Janssen-Cilag, Kreussler, Lilly, and medi.  Gosau R has no conflicts of interest to declare. Radtke MA has received honoraria and travel expenses from Biogen, Pfizer, Abbvie, Celgene, Janssen, MSD, Amgen, Mundipharma, Leo, Almirall and Galderma. Reich K has served as consultant and paid speaker for and participated in clinical trials sponsored by companies that manufacture drugs used for the treatment of psoriasis including Abbvie, Amgen, Biogen, Elgene, Entocor, Ovagen, Forward Pharma, GSK, Janssen- ilag, Leo, Lilly, Medac, MSD, Novartis, Pfizer, Vertex, Takeda. Rustenbach SJ is an employee at the University Medical Center Hamburg-Eppendorf (UKE). Spehr C is an employee at the University Medical Center Hamburg-Eppendorf (UKE). Thaçi D has served as a consultant, investigator, and speaker, and has participated in advisory boards for AbbVie, Amgen, Biogen, Celgene, Eli Lilly, Janssen, Leo Pharma, MSD, Novartis, and Pfizer Inc; and has received research/educational Grants from Abbvie and Pfizer Inc. Augustin M has received honoraria and travel expenses from Abbott, Almirall, Amgen, Biogen, Celgene, Centocor, Janssen-Cilag, Leo, Medac, MSD (formerly Essex, Schering-Plough), Novartis, Pfizer (formerly Wyeth).

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Blome, C., Gosau, R., Radtke, M.A. et al. Patient-relevant treatment goals in psoriasis. Arch Dermatol Res 308, 69–78 (2016). https://doi.org/10.1007/s00403-015-1613-8

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  • DOI: https://doi.org/10.1007/s00403-015-1613-8

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