Photo Credit: Iri-s

Low patient satisfaction in psoriasis and psoriatic arthritis for clinicians and treatment is tied to a need for better communication and shared decision-making.

At this year’s Fall Clinical Dermatology Conference 2024, presenters discussing psoriasis focused on new treatment options, the impact of comorbidities, and advancing patient-centered care, specifically in underserved populations.

A separate study unrelated to the meeting published in the Journal of Psoriasis and Psoriatic Arthritis examined topics of a similar vein, looking at specific goals that patients have regarding psoriasis against the backdrop of advances in treatment.

“Despite advancements in the treatment landscape for psoriasis and psoriatic arthritis, some patients may not achieve the desired disease improvement due to undertreatment,” Jashin J. Wu, MD, FAAD, and colleagues wrote. “Understanding patient perspectives on treatment expectations can inform patient-centered decisions and enhance treatment satisfaction.”

Dr. Wu and colleagues conducted a cross-sectional study that surveyed patients through MyPsoriasisTeam, an online social community. The researchers asked about treatment goals and satisfaction with outcomes and clinicians. The authors summarized participants’ responses with descriptive statistics.

Up to 30% of Patients Dissatisfied With Clinicians 

The study included 386 patients, most of whom had psoriatic arthritis (PsA) with or without psoriasis (n=256). The remaining patients (n=130) had psoriasis (PsO).

Both groups had more women (PsO, 80.0%; PsA, 82.8%), and most patients in both groups fell into the age category of 50-64 (PsA, 55.9%) or 65-79 (PsO, 49.2%). Nearly half of patients in both groups self-reported their disease severity as moderate (PsO, 43.8%; PsA, 42.2%).

Dr. Wu and colleagues found that treatment goals varied by disease type.

Top treatment goals for patients with PsO included:

• Decrease itching (73.1%)
• Reduce the size/thickness of plaques (68.5%)
• Reduce the number of plaques (63.1%)

For patients with PsA, top treatment goals included:

• Decreasing joint pain (77.7%);
• Reducing fatigue (64.8%); and
• Lessening joint stiffness (62.1%).

Overall, both groups reported low satisfaction with treatment. Among patients with PsO, 7.5% reported being extremely satisfied, and 8.5% reported being very satisfied. For patients with PsA, 9.2% reported being extremely satisfied, and 20.2% reported being very satisfied.

Depending on the presence of PsA, patients primarily received treatment from a dermatologist or a dermatologist and a rheumatologist. Overall, 73.1% of patients with PsO saw a dermatologist, while either a dermatologist or a rheumatologist treated 74.6% of patients with PsA.

Up to 30% of patients with either disease reported low satisfaction with clinicians. Among those with PsO, fewer than 20% of patients reported being extremely satisfied (19.3%) or very (19.3%) satisfied. For patients with PsA, 27.3% reported being extremely satisfied; 33.6% reported being very satisfied.

Improving Communication Throughout Treatment

“This cross-sectional study sought to examine patients’ treatment goals and expectations with PsO and PsA and assess their satisfaction with their current treatments and [clinicians], Dr. Wu and colleagues wrote. “The importance of this research lies in achieving a deep understanding of patient attitudes and preferences, which is key to achieving greater satisfaction with treatment, better medication adherence, and improved health outcomes.”

In addition to the lack of satisfaction, many patients reported not discussing or establishing treatment goals with their clinicians. This varied based on the clinician a patient saw, whether a dermatologist only or a dermatologist and a rheumatologist.

Together, the findings indicate “the need for improved communication between patients and [clinicians] to improve patient awareness of available treatment options and align management decisions to self-identified treatment goals,” Dr. Wu and colleagues wrote.

“Enhanced communication and shared decision-making strategies may be used to improve treatment satisfaction and disease management. Patients with PsO and PsA should optimally seek care from a trained specialist: a dermatologist for PsO and a dermatologist or rheumatologist for PsA. Future research should focus on developing and evaluating these strategies and exploring potential barriers to their implementation in clinical practice.”