Improvement of Psoriasis Patients' Adherence to Topical Drugs
Topical drugs are recommended as first-line treatment for mild to moderate psoriasis, but low adherence is a barrier for treatment success. There is a need for supporting psoriasis patients in order to improve their long-term use of topical drugs.
The project aims to test whether a patient-supporting intervention delivered by specialist-trained dermatology nurses can reduce severity of psoriasis and improve the use of topical drugs.
Psoriasis is a chronic inflammatory skin disease affecting 2-4% of the adult Western population. It is associated with many comorbidities, negatively affects quality of life and is a socio-economic burden for patients and society. Topical drugs are the recommended first-line treatment for mild-to-moderate psoriasis, but patients' adherence to treatment is low, which is a barrier for treatment success. Nevertheless, since improved adherence to topical drugs is associated with improved efficacy, there is a need for patient-supporting interventions that improve psoriasis patients' adherence to topical drugs.
To improve the effect of topical therapy in psoriasis patients, there is a need for studying how to optimize the use of the available healthcare professionelas. Since dermatologists are a limited resource, the use of other healthcare professionals, e.g., dermatology nurses, who within a shorter time-period can be trained to support psoriasis patients in their use of topical drugs, may be a practical solution that is cost-effective and has a modest value for improved health outcome.
Improved support from dermatology nurses, with specialist-training in supporting psoriasis patients, could include 1) individualizing treatment plans, 2) providing easy access to dermatology consultation in case of flare-up, 3) giving patients access to digital contact, so they avoid going to the outpatient clinic, and 4) motivating patients to use the medication.
The study investigates if use of topical corticosteroids and/or calcipotriol with a patient-supporting intervention delivered by specialist-trained dermatology nurses supporting psoriasis patients' use of topical drugs significantly 1) reduces the severity of psoriasis, 2) improves quality of life, 3) improves long-term adherence to prescribed topical drugs, and 4) is cost-effective compared to use of topical corticosteroids and/or calcipotriol with standard patient support.
Description of the cohort
Patients with mild-to-severe psoriasis who are 18-85 years of age and have been prescribed topical treatment.
Data and biological material
Questionnaires, clinical assessments and register data.
Collaborating researchers and departments
Department of Dermatology (Center for Dermatology Research), Wake Forest School of Medicine
- Professor Steven Feldman, PhD
Odense Patient Explorative data Network (OPEN), Odense University Hospital
- Associate Professor, Sören Möller, PhD
Danish Centre for Health Economics (DaCHE), University of Southern Denmark
- Project manager Line Planck Kongstad, PhD
Department of Clinical Research, University of Southern Denmark
- Professor Klaus Ejner Andersen, DMSc
Publications associated with the project
Mathias Tiedemann Svendsen, Steven Feldmann, Sylvia Naiga Tiedemann, Anne Sofie Stochholm Sørensen, Cecilie Marie Ringgaard Rivas & Klaus Ejner Andersen (2020) Improving psoriasis patients' adherence to topical drugs: a systematic review, Journal of Dermatological Treatment, 31:8, 776-785, DOI: 10.1080/09546634.2019.1623371
Mathias Tiedemann Svendsen, Steven R. Feldman, Sylvia Naiga Tiedemann, Anne Sofie Stochholm Sørensen, Cecilie Marie Ringgaard Rivas & Klaus Ejner Andersen (2019) Psoriasis patient preferences for topical drugs: a systematic review, Journal of Dermatological Treatment, DOI: 10.1080/09546634.2019.1675855
Mathias Tiedemann Svendsen, Steven R. Feldman, Sylvia Naiga Tiedemann, Anne Sofie Stochholm Sørensen, Cecilie Marie Ringgaard Rivas & Klaus Ejner Andersen (2019) Dermatology nurses view on factors related to Danish psoriasis patients' adherence to topical drugs: a focus group study, Journal of Dermatological Treatment, DOI: 10.1080/09546634.2019.1687817
Svendsen MT, Feldman SR, Tiedemann SN, Sørensen ASS, Rivas CMR, Andersen KE. Limitations in Health-Care System Resources Affecting Adherence of Patient With Psoriasis to Topical Drugs: A Focus Group Study. Journal of Psoriasis and Psoriatic Arthritis. 2020;5(2):54-60. doi:10.1177/2475530320915620
Svendsen MT, Andersen KE. Don't forget the Lattice-System Physician's Global Assessment as one of the research tools for measuring severity of mild-to-moderate psoriasis. J Am Acad Dermatol. 2021 Feb 11:S0190-9622(21)00344-3. doi: 10.1016/j.jaad.2021.02.020. Epub ahead of print. PMID: 33582262.