Table 2.
Themes Associated With patients’ Preferences for Route of Systemic medication Administration.
| The perceived magnitude of benefit and positive impact treatment had on patients’ Quality of Life was greater in patients who received injection medication |
| “Well, to me, it was the life changer for me. You know, in terms of suppressing the immune system, the other stuff treated the symptoms outward symptoms and did nothing internally.” |
| “It was life changing. . . there’s as much mental anguish with the physical aspect of psoriasis and for any other skin disease that’s outwardly seen. . .And you internalize that. . .” |
| “I had gone my whole life putting on oils and creams that don’t really work. They don’t make it stop. They moisturize for 4 hours. So I went through my whole life with no relief at all, except for my nails or brush or comb to scratch. But the shot changed my life.” |
| “Once I started the injections, within that month, my skin cleared up on the hands. . . I Was able to actually do daily routines without gloves on. . .” |
| “The shot made me feel human. . .” |
| Fear of side effects, particularly fear of immunosuppression, is associated with injection systemic medications |
| “I’ve always resisted taking systemic medications because of the effect on your immune system.” |
| “I’m afraid of the immune side effects of that injection.” |
| “I was holding off on injections because of their immune system effects.” |
| “First and foremost it’s the side effects, but two, is that the you know the inconvenience of having to stick yourself.” |
| “I chose. . . Because it carried less side effects overall.” |
| Avoidance of needles drives patients away from injection medication and towards oral systemic medication |
| “It’s a scary when you’re putting a needle into your leg.” |
| “Plus that stuff really stung and hurt. I’ve talked to people that have been on the new formula and they say it’s not as bad, but it’s still stings.” |
| “You know, the whole injecting oneself, I did not enjoy that process. I Had done that. I Was kind of squeamish about it.” |
| “It (injection) started making my legs sink in. . . On my leg where I was taking the shot. . . it’s not a scar., it just like sunk in.” |
| “I would get huge bruises and I just didn’t like that.” |
| The convenience of taking systemic medications motivate patients to use injection and oral systemic medications, respectively |
| “It’s convenient. . . The pen I mean it’s just you know a flash in and out. . .” |
| “The injections. . . it’s fast and easy.” |
| “It’s quick, it’s easy to do it at home, so it’s very convenient and in my case it shipped right to the house.” |
| “With the pill organizer. . . it’s perfect, I can just look and go oh, I need to take my pills.” |
| “It doesn’t bother me to take a daily pill, so I thought that that was very convenient. You know, the whole injecting oneself, I did not enjoy that process.” |
| Patients value the medication recommendation of the physician, regardless of the route of administration |
| “It was what was recommended by my doctor. . .” |
| “I chose to use a systemic medication because it was recommended by the doctor.” |
| “Pretty much whatever the doctor says I do, and I don’t question it. . .” |
| “It wasn’t my decision. It was her (physician) decision.” |
| “I’m more concerned about the overall long-term impact with the biologic, but my physician said you needn’t be concerned. . .” |
| “I would consider anything the doctor wants.” |