Improving psoriasis patients’ adherence to topical drugs: a systematic review

Abstract

Background: Poor adherence to topical antipsoriatic drugs limits treatment effectiveness.

Objective: The aim of this study was to investigate how health care providers may improve psoriasis patients’ adherence to topical treatment.

Materials and methods: A systematic literature search was performed for English-language articles in Embase, Medline, PsycINFO, Cinahl, Scopus, and the Cochrane Library.

Results: Ten studies of varying quality were identified. Two randomized controlled trials (RCTs) testing the adherence-improving potential of interventions by health care providers to support patients showed improvement in adherence to topical treatment. In a prospective study with a pre/postdesign, an individualized, face-to-face consultation reported an improvement in patient-reported adherence to topical treatment over a 9-week period. Based on seven qualitative studies obtaining insights from either patients or health care providers, health care providers may need to address socio-economic factors, health care system factors, and treatment-, patient-, and disease-related factors in interventions that aim to improve the adherence of psoriasis patients to topical antipsoriatic drugs.

Conclusion: There is a need to develop better adherence-improving interventions. A good patient–health care provider relationship is considered crucial to adherence and may be an important intervention target. Before interventions to improve adherence to topicals can be recommended for the clinic, the intervention should be tested in high-quality RCTs.

Keywords:

• Adherence
• health care providers
• psoriasis
• topical antipsoriatic drugs

Acknowledgements

Medical researchers at the Odense University Hospital Library helped formulate the block search strategy and search method design.

Disclosure statement

MTS and KEA have received funding from LEO Pharma. SRF is a speaker for Janssen and Taro, a consultant and speaker for Galderma, Stiefel/GlaxoSmithKline, Abbott Labs, Leo Pharma Inc., has received grants from Galderma, Janssen, Abbott Labs, Amgen, Stiefel/GlaxoSmithKline, Celgene, and Anacor; is a consultant for Amgen, Baxter, Caremark, Gerson Lehrman Group, Guidepoint Global, Hanall Pharmaceutical Co Ltd, Kikaku, Lilly, Merck & Co Inc., Merz Pharmaceuticals, Mylan, Novartis Pharmaceuticals, Pfizer Inc., Qurient, Suncare Research, and Xenoport; is on an advisory board for Pfizer Inc., is the funder of and a shareholder in Causa Research, and is a shareholder in and majority owner of Medical Quality Enhancement Corporation; he receives royalties from UpToDate and Xlibris.

Additional information

Funding

KEA and MTS were supported by a donation from the Kirsten and Volmer Rask Nielsen Foundation.