title: Factors affecting adherence to treatment of psoriasis: comparing biologic therapy to other modalities.
abstract: OBJECTIVE
  This study evaluated self-reported patient adherence to different types of treatment in psoriasis and factors that affect adherence.
  
  
  METHODS
  Patients attending a Dermatology Department for treatments of psoriasis completed a questionnaire about adherence to each of their therapies, Self-assessed Psoriasis Area and Severity Index (SAPASI) and Dermatology Life Quality Index (DLQI).
  
  
  RESULTS
  Hundred and six patients participated, 98 on topical treatments, 43 on oral systemic therapies, 39 on phototherapy and 29 were on biologic therapies. The overall rate of self-reported treatment adherence was 85.8%. There was a significant relationship between the types of treatment (topical, oral systemic, phototherapy and biologic therapy) and the number of combinations of treatments and adherence. Adherence ranked significantly better on biologic therapies 100%, followed by oral therapy 96%, phototherapy 93% and then topical therapy 75%. Being too busy, being fed up and cigarette smoking were associated with reduced adherence. About 56.8% of patients reported that messiness of treatment prevented them from adhering. Patients with mild psoriasis and those with DLQI of 5 or less adhered less to topical therapy.
  
  
  CONCLUSIONS
  There is a significant relationship between the types of treatment (topical, oral systemic, phototherapy and biologic therapy) and the number of combinations of treatments and adherence.
authors.affiliation: Division of Applied Medicine, University of Aberdeen, Aberdeen, UK.
authors.forename: Sue Ann
authors.initials: SA
authors.lastname: Chan
authors.forename: Fawad
authors.initials: F
authors.lastname: Hussain
authors.forename: Linda G
authors.initials: LG
authors.lastname: Lawson
authors.forename: Anthony D
authors.initials: AD
authors.lastname: Ormerod
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D001691:Biological Therapy; D003131:Combined Modality Therapy; D003879:Dermatologic Agents / Q000627:therapeutic use*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010789:Phototherapy; D011565:Psoriasis / Q000628:therapy*; D011788:Quality of Life; D012650:Self Disclosure; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires
chemical_list: D003879:Dermatologic Agents