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20-10-2011 | Psoriasis | Article

Comorbidities influence patient preference for psoriasis treatments


Free abstract

MedWire News: Patient comorbidities should be taken into account when choosing suitable treatments for psoriasis, say researchers, as they can significantly influence treatment preferences.

"Integrating patients' preferences into shared decision-making may facilitate treatment adherence and optimize outcomes," suggest Wiebke Peitsch (Heidelberg University, Mannheim, Germany) and team.

Peitsch and colleagues carried out a survey of 163 patients (58.9% male) with moderate or severe psoriasis, aged 49.3 years on average, to assess what their preferred treatment outcome and process attributes would be. The former included probability, magnitude, and duration of benefit of the treatment and probability, severity, and reversibility of side effects, and the latter, treatment location and frequency, duration of treatment, delivery method, and individual cost.

Of the patients in the cohort, 27.0% had psoriatic arthritis, 13.5% had cardiovascular disease, 8.0% had diabetes, and 12.9% were depressed in addition to having psoriasis.

As reported in the Journal of the American Academy of Dermatology, the researchers found that preferences for treatment attributes varied significantly depending on patient comorbidities.

For example, patients with psoriatic arthritis cared significantly more about benefit than patients with other comorbidities, classified using a relative importance score from 1 to 4 for each attribute where 1 corresponds to a 100% likelihood of the outcome taking place and 4 a 40% likelihood, but tended to care less about the delivery method.

However, patients with cardiovascular disease were very concerned about the potential side effects of the medication they were prescribed, and less concerned about the magnitude of benefit of the treatment.

Patients with depression said that treatment duration and individual cost were very important to them, whereas patients with diabetes tended to care less about probability of benefit and the treatment delivery method than other patients, but these findings were not statistically significant.

"Treatment dissatisfaction and nonadherence is high among psoriasis patients," say Peitsch and co-workers.

They suggest: "Adherence may be improved by integrating preferences into shared decision making."

Peitsch et al conclude: "It is hoped that results of our and other analyses will contribute to optimizing shared decision-making, treatment adherence and satisfaction, and, ultimately, therapeutic efficiency."

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Helen Albert

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