TY - JOUR

T1 - Disease- and treatment-related expectations, attitudes, and beliefs among adult patients initiating or switching biological therapies for psoriasis

AU - Clemmesen, Maria

AU - Jørgensen, Astrid Helene Ravn

AU - Nielsen, Valdemar Wendelboe

AU - Holgersen, Nikolaj

AU - Nissen, Christoffer Valdemar

AU - Thyssen, Jacob Pontoppidan

AU - Egeberg, Alexander

AU - Thomsen, Simon Francis

N1 - Publisher Copyright: © 2023 The Authors. JEADV Clinical Practice published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.

PY - 2023

Y1 - 2023

N2 - Background: The treatment expectations of patients with psoriasis are essential for clinical outcomes. Objectives: To examine disease- and treatment related intra- and interpersonal factors and their relation to treatment expectations among patients with psoriasis who initiate or switch biological therapy. Methods: Consecutive adult patients with moderate to severe psoriasis who initiated or switched biological therapy completed a questionnaire regarding their disease- and treatment-related expectations. Additionally, they filled out Patients' Attitudes and Beliefs Scale (PABS), Trust in Physician Scale (TPS) and Dermatology Life Quality Index (DLQI) questionnaires. Psoriasis Area Severity Index (PASI) was scored before and 3 months after treatment initiation. Results: A total of 65 patients participated; 28% expected <90% clearance of psoriasis following treatment, whereas 72% expected 90%–100% clearance. No differences were found between bionaïve and non-naïve patients. Mutually adjusted analysis showed that female gender (p = 0.026), higher PASI score (p = 0.004) and lower TPS score (p = 0.006) were associated with high overall expectations towards biological therapy. PABS scores were not significantly associated with high expectations. The proportion of patients having low expectations was greatest when asked about work/education, partner interaction and socializing. Additionally, high expectations towards these subjects were associated with higher DLQI (p = 0.047, p = 0.014 and p = 0.056, respectively). Patients with high overall expectations towards biological therapy had a significantly greater reduction in absolute PASI score following treatment (4.7 vs. 2.75), p = 0.048. Conclusions: Techniques aimed at maximizing patients' expectation-effect (placebo response) should be implemented in daily clinical practice. Knowledge about gender, disease severity, impact on life quality and patients' trust in physician should be taken into consideration.

AB - Background: The treatment expectations of patients with psoriasis are essential for clinical outcomes. Objectives: To examine disease- and treatment related intra- and interpersonal factors and their relation to treatment expectations among patients with psoriasis who initiate or switch biological therapy. Methods: Consecutive adult patients with moderate to severe psoriasis who initiated or switched biological therapy completed a questionnaire regarding their disease- and treatment-related expectations. Additionally, they filled out Patients' Attitudes and Beliefs Scale (PABS), Trust in Physician Scale (TPS) and Dermatology Life Quality Index (DLQI) questionnaires. Psoriasis Area Severity Index (PASI) was scored before and 3 months after treatment initiation. Results: A total of 65 patients participated; 28% expected <90% clearance of psoriasis following treatment, whereas 72% expected 90%–100% clearance. No differences were found between bionaïve and non-naïve patients. Mutually adjusted analysis showed that female gender (p = 0.026), higher PASI score (p = 0.004) and lower TPS score (p = 0.006) were associated with high overall expectations towards biological therapy. PABS scores were not significantly associated with high expectations. The proportion of patients having low expectations was greatest when asked about work/education, partner interaction and socializing. Additionally, high expectations towards these subjects were associated with higher DLQI (p = 0.047, p = 0.014 and p = 0.056, respectively). Patients with high overall expectations towards biological therapy had a significantly greater reduction in absolute PASI score following treatment (4.7 vs. 2.75), p = 0.048. Conclusions: Techniques aimed at maximizing patients' expectation-effect (placebo response) should be implemented in daily clinical practice. Knowledge about gender, disease severity, impact on life quality and patients' trust in physician should be taken into consideration.

KW - biological therapy

KW - psoriasis

KW - treatment expectations

U2 - 10.1002/jvc2.218

DO - 10.1002/jvc2.218

M3 - Journal article

AN - SCOPUS:85181454522

VL - 2

SP - 973

EP - 982

JO - JEADV Clinical Practice

JF - JEADV Clinical Practice

SN - 2768-6566

IS - 4

ER -