Adherence and Patient Satisfaction With Topical Treatment in Psoriasis, and the Use, and Organoleptic Properties of Such Treatments: A Delphi Study With an Expert Panel and Members of the Psoriasis Group of the Spanish Academy of Dermatology and Venereology

Background: Topical therapy is key to the successful management of psoriasis, and patient adherence to treatment contributes to its effectiveness in the long-term. Objectives: To establish consensus on adherence to topical treatment in psoriasis, draw up recommendations on how adherence could be improved, and evaluate the properties of the main vehicles used. Method: We designed a questionnaire on adherence to topical treatments in psoriasis and another on the properties of the main vehicles used; the 2 questionnaires were evaluated using the Delphi method by a panel of experts and members of the Psoriasis Group of the Spanish Academy of Dermatology and Venereology, respectively. Results: Consensus was reached on the following statements: a) treatment adherence increases the effectiveness of topical treatments in psoriasis; b) to improve adherence, it is necessary to improve communication between patients and health care staff, provide written instructions, and simplify treatment with easy-to-use, pleasant products that are preferably applied only once a day; c) treatment satisfaction increases adherence and tends to improve the health-related quality of life of the patient. Ointment was rated the worst vehicle, while foams and solutions were rated the best. Creams and lipophilic gels were considered to be better than ointment in several respects. Conclusion: To improve adherence to topical regimens in psoriasis and the effectiveness of such therapy, we need to give patients more information, simplify treatment regimens, and prescribe easy-to-use products that will ensure satisfaction. (C) 2012 Elsevier Espana, S.L. and AEDV. All rights reserved.