Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jun;13(6):1329-1346.
doi: 10.1007/s13555-023-00929-9. Epub 2023 May 15.

Patient and Physician Perceptions of Psoriatic Disease in the United States: Results from the UPLIFT Survey

Affiliations

Patient and Physician Perceptions of Psoriatic Disease in the United States: Results from the UPLIFT Survey

Joseph F Merola et al. Dermatol Ther (Heidelb). 2023 Jun.

Abstract

Introduction: The Understanding Psoriatic Disease Leveraging Insights for Treatment (UPLIFT) survey study was conducted globally in 2020 to understand how disease perceptions, including disease severity, treatment goals, and quality of life (QoL), have evolved recently, especially for mild-to-moderate psoriatic disease. Here, key findings from the UPLIFT survey based on respondents located in the US are presented. Leveraging results from the UPLIFT survey could lead to more effective interactions between patients and physicians and greater patient satisfaction.

Methods: UPLIFT was a multinational web-based survey of dermatologists, rheumatologists, and patients who self-reported a healthcare provider diagnosis of psoriasis (PsO) and/or psoriatic arthritis (PsA) conducted from March 2, 2020, to June 3, 2020.

Results: US respondents included 1006 patients (26.4% of global population; PsO only, n = 535; PsA only, n = 72; PsO and PsA, n = 399) and 216 physicians (dermatologists, n = 115; rheumatologists, n = 101). Most patients (66.4%) reported a body surface area (BSA; assessed by number of palms) of ≤ 3; of these, 56.2% rated their disease as moderate or severe. Most patients with PsO felt they were somewhat (40.1%) or very (49.3%) closely aligned with their dermatologists regarding treatment goals. Alternately, most patients with PsA felt that they were not too closely (32.1%) or not at all (59.3%) aligned with their rheumatologists. Most patients reported either a moderate (PsO, 35.5%; PsA, 31.8%) or strong (PsO, 47.7%; PsA, 53.9%) need for better treatments. Across BSA subgroups, most patients (60.8% to 86.1%) had a Dermatology Life Quality Index score ≥ 6, indicating at least a moderately impacted QoL.

Conclusions: Despite more treatment options, management of psoriatic disease remains suboptimal, with many patients reporting moderate-to-severe disease and impaired QoL, even with limited skin involvement. Results further suggest an unmet need for alignment between patients and physicians in the US to optimize the management of PsO and PsA.

Keywords: Disease burden; Health survey; Patient satisfaction; Psoriasis; Psoriatic arthritis; Quality of life; Special area; Symptom; Treatment goals; United States.

Plain language summary

The Understanding Psoriatic Disease Leveraging Insights for Treatment (UPLIFT) survey was an online survey conducted in 2020. The participants were patients who self-reported a healthcare provider diagnosis of psoriasis and/or psoriatic arthritis, dermatologists, and rheumatologists. The survey was distributed in several countries in North America, Europe, and Japan and a total of 3806 patients responded to the survey. Results from US patients and physicians are presented here.UPLIFT was designed to understand current perceptions of patients and physicians relating to psoriasis and psoriatic arthritis, especially for mild-to-moderate disease. Participants were surveyed regarding treatments, severity of disease, impact on quality of life, treatment goals, and patient-physician interactions.In the US, 1006 patients and 216 physicians completed the survey and were included in the analysis. Most patients had limited skin involvement but still rated their disease as moderate or severe. Regardless of whether patients had a small or large amount of skin involved, most reported at least a moderately impacted quality of life. The survey results suggested that there was disconnect between patients and physicians regarding treatment goals, treatment satisfaction, disease severity, and their recollection of what occurred during physician office visits. Despite new treatment options in recent years, the UPLIFT survey results show that US patients with psoriasis and psoriatic arthritis still experience a great disease burden and could benefit from better communication with physicians to optimize their treatment.

PubMed Disclaimer

Conflict of interest statement

Joseph F. Merola: AbbVie, Amgen, Biogen, Bristol Myers Squibb, Dermavant, Eli Lilly, Janssen, LEO Pharma, Novartis, Pfizer, Regeneron, Sanofi, Sun Pharmaceuticals, and UCB—consultant and/or investigator. Alexis Ogdie: AbbVie, Amgen Inc., Novartis, and Pfizer—grant/research support; AbbVie, Amgen Inc., Bristol Myers Squibb, Celgene, CorEvitas’ Psoriatic Arthritis/Spondyloarthritis Registry (formerly Corrona), Eli Lilly, Gilead, Janssen, Novartis, Pfizer, and UCB—consultant; royalties to husband from Novartis. Alice B. Gottlieb: Amgen, AnaptysBio, Avotres Therapeutics, Boehringer Ingelheim, Bristol Myers Squibb, Dice Therapeutics, Dermavant, Eli Lilly, Janssen, Novartis, Pfizer, Sanofi, Sun Pharma, UCB Pharma, and Xbiotech (stock options for an RA project)—honoraria as an advisory board member, non-promotional speaker or consultant; AnaptysBio, Janssen, Moonlake Therapeutics AG, Novartis, Ortho Dermatologics, Sun Pharma, Bristol Myers Squibb, and UCB Pharma—research/educational grants; all funds go to the Icahn School of Medicine at Mount Sinai. Linda Stein Gold: AbbVie, Amgen, Arcutis, Celgene Corporation, Dermira, Dermavant, Eli Lilly, Galderma, LEO Pharma, Novartis, Pfizer, Regeneron, Sanofi Genzyme, UCB, and Valeant—honoraria, grants, and/or research funding as a speaker, investigator, and/or advisory board member. Andrea Flower, Shauna Jardon, and Yuri Klyachkin: Amgen Inc.—employees and stockholders. Mark Lebwohl: Mount Sinai—employment; AbbVie, Amgen Inc., Arcutis, Boehringer Ingelheim, Dermavant, Eli Lilly, Incyte, Janssen, LEO Pharma, Ortho Dermatologics, Pfizer, and UCB—research funds; Aditum Bio, Allergan, Almirall, Arcutis, Avotres Therapeutics, BirchBioMed, BMD Skincare, Boehringer Ingelheim, Bristol Myers Squibb, Cara Therapeutics, Castle Biosciences, Corrona, Dermavant Sciences, Evelo, Facilitate International Dermatologic Education, Foundation for Research and Education in Dermatology, Inozyme Pharma, Kyowa Kirin, LEO Pharma, Meiji Seika Pharma, Menlo, Mitsubishi, Neuroderm, Pfizer, Promius/Dr. Reddy’s Laboratories, Serono, Theravance, and Verrica—consultant.

Figures

Fig. 1
Fig. 1
Severity of current symptoms by BSA subgroups (patient-reported). aIn response to the following question: “On a scale of 1 to 10, where ‘1’ is ‘very mild’ and ‘10’ is ‘very severe,’ please tell us how severe is your psoriasis currently?” bIn response to the following question: “Based on the amount of psoriasis that could be covered by the palm of your hand (including fingers), how many palms of psoriasis would you say you currently have?” BSA, body surface area
Fig. 2
Fig. 2
Current treatment by level of BSA involvement. Oral plus biologic = oral Rx plus biologic or topical Rx plus oral Rx plus biologic; biologic = biologic only or biologic plus topical Rx; oral = oral Rx only or oral Rx plus topical Rx; topical only = topical Rx only; other = other only or phototherapy only or phototherapy plus other (i.e., anything other than prescription oral/biologic/topical therapy or phototherapy); no Rx treatment = no treatment other than oral OTC or topical OTC. BSA involvement based on patient response to the following question: “Based on the amount of psoriasis that could be covered by the palm of your hand (including fingers), how many palms of psoriasis would you say you currently have?” BSA, body surface area; OTC, over the counter; Rx, prescription
Fig. 3
Fig. 3
DLQI by subgroup. BSA, body surface area; DLQI, Dermatology Life Quality Index; PsA, psoriatic arthritis; PsO, psoriasis
Fig. 4
Fig. 4
DLQI total score categories by special-area involvement. Patients could have involvement in > 1 special area (scalp, face, palms and/or soles, nails, or genital). Brackets show patients with at least a moderate effect. DLQI, Dermatology Life Quality Index; PsO, psoriasis
Fig. 5
Fig. 5
Mean DLQI question scores in patients with and without special-area involvement. DLQI, Dermatology Life Quality Index; PsO, psoriasis

Similar articles

Cited by

References

    1. Elmets CA, Leonardi CL, Davis DMR, Gelfand JM, Lichten J, Mehta NN, et al. Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with awareness and attention to comorbidities. J Am Acad Dermatol. 2019;80:1073–1113. doi: 10.1016/j.jaad.2018.11.058. - DOI - PubMed
    1. Mrowietz U, Kragballe K, Reich K, Spuls P, Griffiths CE, Nast A, et al. Definition of treatment goals for moderate to severe psoriasis: a European consensus. Arch Dermatol Res. 2011;303:1–10. doi: 10.1007/s00403-010-1080-1. - DOI - PMC - PubMed
    1. Nast A, Smith C, Spuls PI, Avila Valle G, Bata-Csörgö Z, Boonen H, et al. EuroGuiDerm Guideline on the systemic treatment of psoriasis vulgaris—Part 1: treatment and monitoring recommendations. J Eur Acad Dermatol Venereol. 2020;34:2461–2498. doi: 10.1111/jdv.16915. - DOI - PubMed
    1. Armstrong AW, Mehta MD, Schupp CW, Gondo GC, Bell SJ, Griffiths CEM. Psoriasis prevalence in adults in the United States. JAMA Dermatol. 2021;157:940–946. doi: 10.1001/jamadermatol.2021.2007. - DOI - PMC - PubMed
    1. Mease PJ, Gladman DD, Papp KA, Khraishi MM, Thaci D, Behrens F, et al. Prevalence of rheumatologist-diagnosed psoriatic arthritis in patients with psoriasis in European/North American dermatology clinics. J Am Acad Dermatol. 2013;69:729–735. doi: 10.1016/j.jaad.2013.07.023. - DOI - PubMed