Table 3.
Overview of included studies: Psoriasis
| Authors and Year | Sample characteristics, origin, and design | Factors measured | Analysis | Non-adherence: target, measure and extent | ||||
|---|---|---|---|---|---|---|---|---|
| Demographic | Clinical | Treatment | Psychosocial | |||||
| Altobelli et al. (2012) |
Sample: Psoriasis outpatients N: 1689 Age: 48.6 (SD = 15.0) men; 47.4 (SD = 15.5) women Male: 56.8% Origin: Italy Design: cross-sectional Quality: 9/16 (56.3%) |
Gender, age, education, marital status, employment status | Psoriasis type (disease type), age at onset, disease-duration, affected body sites and body surface area affected | Univariate | Target | All modalities (topical, systemic and alternative treatments) | ||
| Measure | Questionnaire | |||||||
| Extent | 54.1% | |||||||
| Bhosle et al. (2006) |
Sample: Psoriasis patients on Medicaid programme in North Carolina N: 186 Median age: 41.0 (SD = 11.44) Male: 41.4% Origin: USA Design: longitudinal Cohort Quality: 9/13 (69.2%) |
Age, gender, ethnicity | Co-morbidity | medication type, combination therapy | Multivariate (prospective) + sensitivity analysis | Target | Biologics (alefacept, efalizumab etanercept, 80% on combination therapy) | |
| Measure | Prescription refill records (MPR) | |||||||
| Extent |
44.0% overall 34.0% biologics |
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| Chan et al. (2013) |
Sample: Psoriasis outpatients N: 106 Mean age: NR Male: 50% Origin: UK Design: cross-sectional Quality: 8/16 (50.0%) |
Age, gender, marital status, employment status, educational level | Disease severity (topical therapy only) | Number of treatment types, medication type | Lifestyle (smoking alcohol use), treatment efficacy, treatment satisfaction, practical barriers (fed up, too busy lotions too messy), QoL (topical therapy only) | Univariate | Target | Topical, oral systemic, phototherapy, biologics |
| Measure | Self-reported questionnaire | |||||||
| Extent | 14.2% | |||||||
| Chastek et al. (2013) |
Sample: Psoriasis outpatients N: 827 Age: 43 (SD = 12) Male: 52–56% Origin: USA Design: retrospective Pharmacy database Quality: 6/12 (50.0%) |
Medication type | Univariate | Target | Biologics (Etanercept and adalimumab) | |||
| Measure | Persistence over 12 months (Medication refills) | |||||||
| Extent | 59.6% Etanercept, 57.6% Adalimumab | |||||||
| Clemmensen et al. (2011) |
Sample: Psoriasis outpatients N: 71 Mean age: 43.1 (SD = 13.0) Male: 51% Origin: Denmark Design: Cohort Quality: 5/12 (41.7%) |
Medication type | Multivariate (prospective) | Target | Biologics (ustekinumab, adalimumab, etanercept) | |||
| Measure | Patient medical records (persistence) | |||||||
| Extent | 4.2% (321 days) | |||||||
| Esposito et al. (2013) |
Sample: Psoriasis patients from medical/digital databases N: 650 Mean age: 49.0 (SD = 13.1) Male: 66% Origin: Italy Design: retrospective cohort Quality: 7/12 (58.3%) |
Age, gender | Disease severity (Psoriasis area and severity index) | Medication type | Univariate | Target | aTNF (adalimumab, etanercept, infliximab) | |
| Measure | Patient medical records (persistence) | |||||||
| Extent | 27.4% at 2 years | |||||||
| Gniadecki et al. (2011) |
Sample: psoriasis patients N: 747 Mean age: 45.0 (SD NR) Male: 67% Origin: Denmark Design: Cohort Quality: 6/12 (50.0%) |
Age, gender | Disease duration, presence of psoriatic arthritis, Co-morbidity | Concomitant medication, prior treatment (prior use of anti-TNF), medication type | QoL | Multivariate | Target | Biologics (infliximab, adalimumab, etanercept) |
| Measure | Patient medical records (persistence) | |||||||
| Extent |
32.3% overall Infliximab 25.58% Adalimumab 32.0% Etanercept 36.2% |
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| Gokdemir et al. (2008) |
Sample: Psoriasis patients N: 109 Mean age: 40.1 (SD = 15.2) Male: 44% Origin: Turkey Design: cross-sectional Quality: 5/14 (35.7%) |
Gender, marital status, education level, employment status, family history (note demographic factors not significant in multivariate analysis) | Disease severity | Medication type | Lifestyle (smoking), QoL, satisfaction with treatment | Univariate and multivariate (prospective) | Target | Topical, oral, combined and phototherapy |
| Measure | Number or weight of prescribed doses taken by the patient/number or weight of doses prescribed for the patient × 100% | |||||||
| Extent | Not given | |||||||
| Richards et al. (1999) |
Sample: Psoriasis outpatients N: 120 Mean age: 49.0 (SD = 16.0) Male: 54% Origin: UK Design: cross-sectional Quality: 6/16 (37.5%) |
Age, gender | Age at onset, disease duration, disease severity | General well-being, impact on life, interfered with life | Univariate | Target | Topical, systemic, combination and phototherapy | |
| Measure | Self-reported questionnaire | |||||||
| Extent | 39.0% | |||||||
| Umezawa et al. (2013) |
Sample: Psoriasis outpatients N: 127 Mean age: I:A:U = 52.1:50.1:62.3 (SD = 11.4:10.7:12.3) Male: 72% Origin: Japan Design: longitudinal Quality: 5/14 (35.7%) |
Medication type | Univariate and Multivariate | Target | Infliximab, adalimumab and ustekinumab | |||
| Measure | Drug survival rate (at 12 month follow-up) | |||||||
| Extent |
Proportion discontinuing (less than a year): Infliximab—26.3% Adalimumab—20.3% Ustekinumab—3.3% |
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| Zaghloul and Goodfield (2004) |
Sample: Psoriasis outpatients N: 201 Mean age: 45.1 (SD = 10.1) Male: NR Origin: UK Design: longitudinal Quality: 4/16 (25.0%) |
Age, gender, marital status, employment status, medication payment | Disease severity, lesion location, Number of lesions | Medication type, Medication frequency, previous treatment (naïve to treatment), side effects | QoL, lifestyle (smoking, alcohol consumption) | Univariate | Target | Topical and oral |
| Measure |
Number or weight of prescribed doses taken by the patient/number or weight of doses prescribed for the patient × 100% Self-report interview |
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| Extent |
Number of doses or weight: 60.6% Self-report: 92.0% |
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Factors found to be associated with treatment adherence highlighted in bold
aTNF anti-tumor necrosis factor, MPR medication possession ratio, NR not recorded, QoL quality of life, SD standard deviation