Psoriasis Review

NONADHERENCE IN PSORIASIS OFTEN INFLUENCED BY PATIENTS’ BELIEFS

Patients’ beliefs about medication and habit strength are promising targets for the improvement of medication ad-
herence in patients with psoriasis, according to a recent study.

Medication nonadherence often interferes with therapeutic benefit in the treatment of psoriasis. To explore real-world levels of self-reported medication nonadherence and potential barriers to adherence, the researchers evaluated 811 patients with psoriasis who were enrolled in the British Association of Dermatologists Biologic Interventions Register via multivariable analyses. Latent profile analysis (LPA) was implemented to determine whether patients could be classified into groups with similar beliefs about medication and represented by a categorical latent variable.

A total of 617 patients used a selfadministered systemic therapy. Results indicated that 22.4% of patients were nonadherent, of whom 12% were intentionally nonadherent and 10.9% were unintentionally nonadherent. The researchers found that more patients who used an oral conventional systemic agent (29.2%) were nonadherent to treatment vs those who used etanercept (Enbrel) or adalimumab (Humira) (16.4%).They also noted that LPA supported a 3-group model.

Strong beliefs were held by all groups regarding their need for systemic therapy. However, according to the researchers, their beliefs differed by degree of medication concerns. Group 1 (26.4% of the cohort) had the strongest concerns, followed by group 2 (61%) and group 3 (12.6%). Group 1 was associated with intentional nonadherence (odds ratio [OR] 2.27), and weaker medication-related habit strength was associated with unintentional nonadherence (OR 0.92).

“Medication beliefs and habit strength are modifiable targets for strategies to improve adherence in psoriasis,” the researchers concluded.

Reference
Thorneloe RJ, Griffiths CEM, Emsley R, Ashcroft DM, Cordingley L; BADBIR and PSORT Study Groups. Intentional and unintentional medication non-adherence in psoriasis: the role of patients’ medication beliefs and habit strength [published online November 25, 2017]. J Invest Dermatol. doi:10.1016/j.jid.2017.11.015