Evaluating Treatment Goals, Preferences in Parents and Young Patients With Psoriasis

Pediatric populations, young adults, and parents all identified differing goals and preferences of treatment for psoriasis, with the most important treatment goals overall cited as lesion prevention and reduction.

Individual goals and preferences regarding treatment of psoriasis differed across age groups of pediatric and young adult populations, with both groups reporting similar goals of clearing lesions and itch with effective and safe therapies. Results were published in the Journal of Dermatological Treatment.

In the management of patients with psoriasis, addressing quality of life, encompassing physical, emotional, and psychological effects, has become of critical importance in optimizing treatment outcomes.

Notably, as children and young adults progress through developmental stages, patient-centered approaches early on may differ from those at later stages of life, but researchers note that little information is available regarding the needs and treatment goals of these populations and their parents.

“The recent increase in therapeutic options for pediatric patients with psoriasis emphasizes the need to consider their preferences and needs even more,” said researchers. “A greater understanding of needs, treatment goals, and preferences in young patients with psoriasis and their parents may advance personalized care.”

Aiming to explore the differences in treatment goals and preferences of these patient populations, they conducted an observational study of responses garnered via web-based surveys among 195 young Dutch patients with psoriasis aged 6 to 30 years (mean [SD] age, 20.2 [6.3] years) and 45 parents between May 16 and November 16, 2020.

In the study, the treatment goals and preferences of pediatric patients (n = 64; aged 6-17 years), young adult patients (n = 131; aged 18-30 years), and parents were compared, with patient needs further differentiated according to gender, current treatment, self-reported disease severity, and disease characteristics (eg, genital psoriasis, lesions visible to others).

Across the study cohort, a majority had plaque psoriasis and/or scalp psoriasis and were mainly treated with topical therapy as either monotherapy or in addition to systemic treatment, followed by conventional systemic therapy and biologics.

Overall, the most important treatment goals of patients identified in the surveys included preventing lesions (mean [SD], 2.70 [0.58]), reducing lesions (mean [SD], 2.65 [0.59]), experiencing no itch (mean [SD], 2.49 [0.75]), and having no lesions (mean [SD], 2.32 [0.87]).

Regarding the most important treatment characteristic preferences of patients, responses of long-term safety (mean [SD], 2.66 [0.52]), high effectiveness (mean [SD], 2.53 [0.51]), and short-term safety (mean [SD], 2.47 [0.58]) were noted.

When assessing differences by age, gender, and current treatment, several patient preferences were found:

  • Pediatric patients rated not sticky, quick results, and no/few blood samples needed higher than parents and/or young adults.
  • Young adults rated feeling more confident and better quality of sleep higher than pediatric patients.
  • Parents considered safety most important.
  • Psychosocial goals were more important for women and patients on biologics.

“These differences emphasize the relevance of incorporating individual patient needs in the shared decision making process with physicians and patients, and indicate that patient needs may alter when going through different stages of life,” concluded researchers. “To provide optimal care, interactive counseling should address the different needs of pediatric patients and their parents.”

Reference

Schaap MJ, Broekhuis SCE, Spillekom-van Koulil S, Groenewoud HMM, de Jong EMGJ, Seyger MMB. Treatment goals and preferences of pediatric psoriasis patients, young adults, and parents. J Dermatolog Treat. Published online October 8, 2021. doi:10.1080/09546634.2021.1985058