Background and importance Searching for novel methods that could increase the effectiveness of treatment with biological drugs we wanted to carry out a study to evaluate the measurement of patient activation.
Aim and objectives To evaluate activation according to the Patient Activation Measure-13 (PAM-13) questionnaire and to analyse the relationship between adherence and health outcomes in patients with moderate to severe psoriasis treated with biological drugs.
Material and methods Design: prospective observational study. Inclusion criteria: patients with moderate to severe psoriasis treated with biological drugs for more than 6 months, who attended dermatology consultations from 1 June 2020 to 1 July 2020. Variables: demographic (sex and age), related to treatment (time under treatment with biological drugs and study drug) and related to effectiveness (Psoriasis Area Severity Index (PASI): non-responders PASI ≥5).
The patient’s ability to play an active role in health care was measured using the PAM-13 questionnaire: not active ≤55.1 and active ≥55.2.
Adherence to treatment was assessed by combining the Simplified Medication Adherence Questionnaire (SMAQ) and the rate of possession of the medication at 6–12 months (TPM; adherents TPM ≥80%). Non-adherent patients were those classified as non-adherent according to either of the two methods.
Results 31 patients (45% women) were included, with a mean of 48 years (95% CI 44 to 52), in treatment with biologics for 3.6 years (IQR 3.5); in active treatment with: adalimumab (32%; 10/31), secukinumab (29%; 9/31), ixekizumab (19%; 6/31) or others (19%; 6/31).
Two patients were considered to be non-responders (6%; 2/31). The PAM-13 classified 19% (6/31) of the patients as not activated. 29% (9/31) were considered non-adherent.
When associating activation with adherence, no differences were observed (χ2=1.6; p=0.208) with 50% (3/6) of non-activated patients considered non-adherent.
When relating activation to effectiveness, statistically significant differences were observed (χ2=8.9; p=0.003). The two non-responders were considered unactivated, while 86% (25/29) of the responding patients were considered activated.
Conclusion and relevance The higher proportion of responding patients found among activated patients indicates a positive relationship between activation and health outcomes, so promoting patient activation could contribute to improving the effectiveness of biological drugs in patients with moderate to severe psoriasis.
Conflict of interest No conflict of interest
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