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. 2022 Aug 25:12:221-230.
doi: 10.2147/PTT.S375173. eCollection 2022.

Therapeutic Inertia in the Management of Psoriasis: A Quantitative Survey Among Indian Dermatologists and Patients

Murlidhar Rajagopalan  1 , Sunil Dogra  2 , Kiran Godse  3 , Bikash Ranjan Kar  4 , Sai Krishna Kotla  5 , Shekhar Neema  6 , Abir Saraswat  7 , Swapnil Deepak Shah  8 , Nina Madnani  9   10 , Vidyadhar Sardesai  11 , Rajiv Sekhri  12 , Sachin Varma  13 , Sandeep Arora  14 , Pallavi Kawatra  15
Affiliations

Therapeutic Inertia in the Management of Psoriasis: A Quantitative Survey Among Indian Dermatologists and Patients

Murlidhar Rajagopalan et al. Psoriasis (Auckl). .

Abstract

Purpose: The primary objective of the study was to understand the therapeutic inertia in treatment and management of plaque psoriasis among dermatologists, along with determining the preferred treatment choices for management of plaque psoriasis; it also included the resulting treatment satisfaction among patients. The secondary objective was to identify the gaps in terms of knowledge and attitude among dermatologists and the expectations of patients.

Patients and methods: A multicentre, cross-sectional quantitative survey was conducted among dermatologists and patients with moderate to severe plaque psoriasis across India. The interviews were conducted either face to face or via telephone between September and November 2020, using structured and validated questionnaires based on specific themes. The data obtained were statistically analysed, wherever applicable.

Results: Overall, 207 adult patients with moderate-to-severe plaque psoriasis and 303 dermatologists were interviewed. Post experiencing symptoms, 44% of the patients visited general physicians for treatment and there was an average 7.8-month delay by the patients to consult a dermatologist. Approximately one-fourth of patients used home remedies before seeking medical help. One-third of dermatologists used the Psoriasis Area and Severity Index (PASI) for assessing the disease severity. Majority of dermatologists preferred combination therapy for their patients. The lack of quick resolution and side effects were the major reasons for changing the treatment. Overall, only 35% of the patients complied to current treatment. Satisfaction with existing forms of therapies was highest for mild plaque psoriasis (62%) as confirmed by dermatologists, while 52% of the overall patients were satisfied with their therapy. Majority of the patients (64%) affirmed living with plaque psoriasis impacted their lives.

Conclusion: This first-of-its-kind survey in India highlighted the gaps in terms of the disease journey between dermatologists and patients. The survey emphasises the need for shared decision-making and may benefit dermatologists in suggestive modifications of the treatment algorithm and disease management in clinical settings.

Keywords: adherence; diagnosis; psoriasis; therapeutic inertia; treatment expectations; treatment goals.

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Conflict of interest statement

Dr Pallavi Kawatra is an employee of Novartis Healthcare Pvt Ltd, India. Dr Murlidhar Rajagopalan reports personal fees from Novartis, during the conduct of the study; is a speaker and advisor for Novartis,Sanofi, Janssen, Pfizer, Sun Pharma, Gracewell, Dr Reddy's Labs, Eli Lilly, Zydus Cadila, Merck Sharpe and Dohme and has received honoraria for lectures. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Overall distribution of the symptoms experienced at the initial diagnosis. More than one option can be selected by the respondents.
Figure 2
Figure 2
Treatment expectations by patients and dermatologists' perspective of patient expectations.
See this image and copyright information in PMC

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References

    1. Griffiths CEM, Armstrong AW, Gudjonsson JE, Barker JN. Psoriasis. Lancet. 2021;397(10281):1301–1315. doi:10.1016/S0140-6736(20)32549-6 - DOI - PubMed
    1. Parisi R, Iskandar IYK, Kontopantelis E, Augustin M, Griffiths CEM, Ashcroft DM. National, regional, and worldwide epidemiology of psoriasis: systematic analysis and modelling study. BMJ. 2020;369:m1590. doi:10.1136/bmj.m1590 - DOI - PMC - PubMed
    1. Prevalence data. Available from: https://www.globalpsoriasisatlas.org/en/statistics/prevalence-data. Accessed January 4, 2021.
    1. Dogra S, Yadav S. Psoriasis in India: prevalence and pattern. Indian J Dermatol Venereol Leprol. 2010;76(6):595–601. doi:10.4103/0378-6323.72443 - DOI - PubMed
    1. Raychaudhuri SP, Rein G, Farber EM. Neuropathogenesis and neuropharmacology of psoriasis. Int J Dermatol. 1995;34(10):685–693. doi:10.1111/j.1365-4362.1995.tb04653.x - DOI - PubMed