K Reich1,2, I Zschocke2, H Bachelez3, E M G J de Jong4, P Gisondi5, L Puig6, R B Warren7, C Ortland8, U Mrowietz9. 1. Dermatologikum Hamburg, Hamburg, Germany. 2. SCIderm GmbH, Hamburg, Germany. 3. Sorbonne Paris Cité Université Paris-Diderot, AP-HP Hôpital Saint-Louis, Paris, France. 4. Radboud University Medical Centre and Radboud University, Nijmegen, the Netherlands. 5. Dermatology and Venerology Section, University of Verona, Verona, Italy. 6. Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain. 7. The Dermatology Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K. 8. Das Forschungsdock Service for Clinical Development, Schenefeld, Germany. 9. Psoriasis Center, Department of Dermatology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany.
Abstract
BACKGROUND: Around two-thirds of patients with psoriasis do not adhere to topical treatment. The Topical Treatment Optimization Programme (TTOP), a five-element tool, includes guidance for the conversation between dermatologists/nurses and patients, patient information material, telephone/e-mail helpdesks and treatment reminders. It has been developed by patients and dermatologists to help increase adherence to treatment in psoriasis. OBJECTIVES: To compare TTOP with standard of care ('non-TTOP') within a large European investigator-initiated study, PSO-TOP (clinicaltrials.gov NCT01587755). METHODS:Patients with mild-to-moderate psoriasis received calcipotriol/betamethasone dipropionate gel as standardized study medication and were randomized 1 : 1 to either TTOP or non-TTOP management. Study medication was applied once daily for 8 weeks followed by 'as needed' application for an additional 56 weeks. Response was defined as a Physician's Global Assessment (PGA) of 'clear' or 'almost clear'. RESULTS: In 1790 patients (full analysis set), response rates after 8 weeks (primary objective) were significantly higher for TTOP (36·3%) than for non-TTOP (31·3%, P = 0·0267). Better clinical outcome was accompanied by higher rates of patients feeling well informed about their skin condition, treatment and other factors related to adherence, but the Dermatology Life Quality Index was not statistically different. TTOP patients regarded the structured one-to-one conversations with their dermatologist/nurse as the most important element of TTOP. CONCLUSIONS: Patients randomized to the TTOP intervention had a better clinical response than patients receiving standard of care. Improved communication between the healthcare provider and patient might be an important element in increasing adherence to topical therapy in psoriasis.
RCT Entities:
BACKGROUND: Around two-thirds of patients with psoriasis do not adhere to topical treatment. The Topical Treatment Optimization Programme (TTOP), a five-element tool, includes guidance for the conversation between dermatologists/nurses and patients, patient information material, telephone/e-mail helpdesks and treatment reminders. It has been developed by patients and dermatologists to help increase adherence to treatment in psoriasis. OBJECTIVES: To compare TTOP with standard of care ('non-TTOP') within a large European investigator-initiated study, PSO-TOP (clinicaltrials.gov NCT01587755). METHODS:Patients with mild-to-moderate psoriasis received calcipotriol/betamethasone dipropionate gel as standardized study medication and were randomized 1 : 1 to either TTOP or non-TTOP management. Study medication was applied once daily for 8 weeks followed by 'as needed' application for an additional 56 weeks. Response was defined as a Physician's Global Assessment (PGA) of 'clear' or 'almost clear'. RESULTS: In 1790 patients (full analysis set), response rates after 8 weeks (primary objective) were significantly higher for TTOP (36·3%) than for non-TTOP (31·3%, P = 0·0267). Better clinical outcome was accompanied by higher rates of patients feeling well informed about their skin condition, treatment and other factors related to adherence, but the Dermatology Life Quality Index was not statistically different. TTOP patients regarded the structured one-to-one conversations with their dermatologist/nurse as the most important element of TTOP. CONCLUSIONS:Patients randomized to the TTOP intervention had a better clinical response than patients receiving standard of care. Improved communication between the healthcare provider and patient might be an important element in increasing adherence to topical therapy in psoriasis.
Authors: Shinichi Imafuku; Min Zheng; Yayoi Tada; Xibao Zhang; Colin Theng; Suganthi Thevarajah; Yi Zhao; Hae Jun Song Journal: J Dermatol Date: 2018-05-09 Impact factor: 4.005
Authors: Linda Stein Gold; Javier Alonso-Llamazares; Jean-Philippe Lacour; Richard B Warren; Stephen K Tyring; Leon Kircik; Paul Yamauchi; Mark Lebwohl Journal: Adv Ther Date: 2020-09-23 Impact factor: 3.845
Authors: Diamant Thaçi; Pablo de la Cueva; Andrew E Pink; Ahmad Jalili; Siegfried Segaert; Kasper F Hjuler; Piergiacomo Calzavara-Pinton Journal: BJGP Open Date: 2020-12-15