Patient Needs, Treatment Goals in Psoriasis Vary by Gender and Age
The least important item to patients was “be able to lead a normal working life.”
Women with psoriasis have higher treatment expectations and more specific needs than men with psoriasis, with particular concern for everyday productivity, sleep quality, and depression, according to study results published in the Journal of the European Academy of Dermatology and Venerology. Older patients with psoriasis also have different needs and expectations compared with younger patients.
Most clinicians regard patient needs as a key driver of treatment decisions, but these needs are rarely systematically investigated. In the current study, researchers analyzed patient needs and expectations using the national psoriasis registries of Switzerland (Swiss Dermatology Network of Targeted Therapies [SDNTT]; ClinicalTrials.gov identifier: NCT01706692) and Germany (PsoBest; ClinicalTrials.gov identifier: NCT01848028), with respect to age, gender, and treatment choice. These real-life data correspond to patient experiences in routine care between 2008 and 2016, with a mean follow-up of 7.5 months.
A total of 5343 patients (59.6% male, mean age 47.6±14.5 years at baseline) were included in the analyses (449 from SDNTT and 4894 from PsoBest). The overall most important patient needs cited were to see skin improvements quickly and to have all skin defects healed, both of which were rated as "quite/very important" by 94.0% of patients.
Although social needs such as "to be comfortable showing yourself more in public" were of greater concern for patients <65 years old than patients >65 (mean Patient Needs Questionnaire [PNQ] score of 3.1 vs 2.6, P ≤.001), patients >65 were more concerned with side effects (mean PNQ 2.9 vs 2.8, P ≤.031), sleep quality (mean PNQ 2.2 vs 2.1, P ≤.024), and being less dependent on medical visits (mean PNQ 3.2 vs 3.1, P ≤.001).
Women rated 20 out of 25 items as significantly more important than men, with everyday productivity, sleep quality, and depression showing the greatest differences.
Study investigators suggest "for treatment decisions, individual patient needs should be examined to identify and appropriately address patient-derived concerns. Some needs statements showed more distinct answer patterns than others, leading to a higher variance. A better understanding of patient needs could help physicians achieve better therapy outcomes, higher patient satisfaction and quality of care."
Disclosures: The registries used in this study are supported by AbbVie, Amgen, Almirall, Biogen, Celgene, Hexal, Janssen-Cilag, LEO Pharma, Eli Lilly, medac, Novartis, and Pfizer. Multiple authors disclosed affiliations with pharmaceutical companies. See the reference for complete disclosure information.
Maul JT, Navarini AA, Sommer R, et al. Gender and age significantly determine patient needs and treatment goals in psoriasis - a lesson for practice [published online November 2, 2018]. J Eur Acad Dermatol Venereol. doi: 10.1111/jdv.15324