Patients’ Preferences Regarding Modes of Systemic Psoriasis Treatment – A Qualitative Study
Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine
How they used Delve
Dermatology researchers at Wake Forest used Delve to code 22 patient interviews about psoriasis treatment preferences, with two researchers coding independently and meeting to reconcile, organising codes into themes and then reviewing each theme for subthemes.
“[Identifying information] was removed from all transcriptions, documents password protected to protect participant privacy, and files uploaded to Delve qualitative data analysis software for analysis. The transcripts were (re)read and codes were created. Codes were organized into themes and themes reviewed for subthemes.”
- Field
- Dermatology; what makes psoriasis patients prefer oral systemic drugs over injectable biologics, or the reverse
- Data
- Semi-structured interviews with 22 psoriasis patients on systemic treatment (12 men, 10 women): 10 receiving oral medication (apremilast or methotrexate) and 12 receiving injectables (guselkumab, adalimumab, risankizumab, secukinumab, ixekizumab or tildrakizumab), each by self-reported preference
- Approach
- Semi-structured interviews sampled to saturation with equal numbers preferring oral and injectable treatment. Identifying information was stripped from the transcripts and the password-protected files uploaded to Delve, where transcripts were re-read, codes created, codes organised into themes and themes reviewed for subthemes. Two members of the research team read and coded the interviews independently and met multiple times to work through their readings.
- Data types
- Interviews
Abstract
Background: Treatment with pathogenesis-directed biologics and oral systemic drugs have made complete clearance of psoriasis a realistic expectation for many patients with psoriasis. Patients’ preferences among these treatments varies. Objective: To understand factors impacting psoriasis patients’preferences for injection vs oral medication. Methods: Psoriasis patients who receive systemic psoriasis treatment were asked to participate in a semi-structured interview. Sample size was based on achieving saturation with equal number of patients preferring oral vs injectable medications to ensure equal representation of both groups. Qualitative analysis was performed to interpret the results. Results: Twenty-two patients participated in the study, 12 males and 10 females. Ten patients were receiving oral medication (apremilast or methotrexate) and 12 patients were receiving injectables (guselkumab, adalimumab, risankizumab, secukinumab, ixekizumab, or tildrakizumab) due to self-reported preference. Five themes resulted from the analysis: patients receiving injectables more frequently discussed the positive impact of the medication on quality of life compared to patients on oral medication; fear of side effects, particularly fear of immunosuppression, is associated with injection medications; avoidance of needles drives patients away from injection medication and towards oral systemic medication; patients prioritize convenience when selecting systemic therapy, though the definition of convenience is subject to perception; and patients value the medication recommendation of the physician, regardless of the route of administration. Conclusion: Improving medication adherence and disease outcomes through individualized treatment plans, with an emphasis on patients’ preferences using a shared decision-making approach, may be helpful.
Citation
Mallory Zaino, Emily A. Parks, Jasmine McNeil, Steven R. Feldman (2024). Patients’ Preferences Regarding Modes of Systemic Psoriasis Treatment – A Qualitative Study. Journal of Psoriasis and Psoriatic Arthritis. https://doi.org/10.1177/24755303241253200