title: Patient satisfaction with treatments for moderate-to-severe plaque psoriasis in clinical practice.
abstract: BACKGROUND
  Treatment satisfaction among patients with moderate-to-severe psoriasis has not been studied and compared across treatments using a validated instrument.
  
  
  OBJECTIVE
  To assess patient-reported satisfaction with systemic and phototherapy treatments for moderate-to-severe psoriasis in clinical practice and to correlate satisfaction with disease severity and quality-of-life measures.
  
  
  METHODS
  This was a cross-sectional study of 1182 patients with moderate-to-severe psoriasis in the Dermatology Clinical Effectiveness Research Network in the U.S.A. Patients receiving either topical therapies only; monotherapy with oral systemic therapies, biologics or narrowband ultraviolet B phototherapy; or combination therapy with biologics and methotrexate completed the Treatment Satisfaction Questionnaire for Medication version II.
  
  
  RESULTS
  Median unadjusted overall satisfaction scores were highest for patients receiving biologic monotherapies, biologic-methotrexate combinations, or phototherapy (83.3); scores were lowest for those receiving topical therapies only or acitretin (66.7). In fully adjusted models, compared with patients receiving methotrexate monotherapy, those receiving adalimumab, etanercept, ustekinumab, phototherapy or adalimumab with methotrexate had significantly higher median overall satisfaction scores by 7.2-8.3 points, while those receiving topical therapies only had significantly lower overall satisfaction by 8.9 points. Adjusted convenience scores were lowest for patients receiving topical therapies only or infliximab. Modest but significant correlations were found between the overall satisfaction subscale and both the Psoriasis Area and Severity Index (ρ = -0.36, P < 0.001) and the Dermatology Life Quality Index (ρ = -0.47, P < 0.001).
  
  
  CONCLUSIONS
  Discernible differences were found in treatment satisfaction among therapies, particularly regarding treatment effectiveness and convenience. Further application of treatment satisfaction measures may inform treatment decisions and guideline development.
authors.affiliation: Department of Dermatology, University of Utah School of Medicine, Salt Lake City, UT, USA.
authors.forename: K Callis
authors.initials: KC
authors.lastname: Duffin
authors.affiliation: Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: H
authors.initials: H
authors.lastname: Yeung
authors.affiliation: Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.|Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
authors.forename: J
authors.initials: J
authors.lastname: Takeshita
authors.affiliation: Department of Dermatology, University of Utah School of Medicine, Salt Lake City, UT, USA.
authors.forename: G G
authors.initials: GG
authors.lastname: Krueger
authors.affiliation: National Psoriasis Foundation, Portland, OR, USA.
authors.forename: A D
authors.initials: AD
authors.lastname: Robertson
authors.affiliation: Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.|Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
authors.forename: A B
authors.initials: AB
authors.lastname: Troxel
authors.affiliation: Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.|Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.|Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
authors.forename: D B
authors.initials: DB
authors.lastname: Shin
authors.affiliation: Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
authors.forename: A S
authors.initials: AS
authors.lastname: Van Voorhees
authors.affiliation: Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.|Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Gelfand
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003879:Dermatologic Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011565:Psoriasis / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014467:Ultraviolet Therapy / Q000523:psychology
chemical_list: D003879:Dermatologic Agents