OBJECTIVES: This multi-stage study aimed to design and validate a patient treatment acceptability outcome measure that is fit-for-purpose across the psoriasis disease severity spectrum.

METHODS: Stage 1 involved a group concept mapping (GCM) exercise to explore and understand patient perspectives and unmet needs in psoriasis treatment in patients newly diagnosed with mild psoriasis. The GCM results for mild psoriasis were added to the concepts and domains generated in a previous study with dermatologists and participants with moderate to severe psoriasis. In Stage 2, qualitative interviews with participants across the psoriasis severity spectrum were conducted to cognitively debrief the tool designed in Stage 1.

RESULTS: Forty patients participated in Stages 1 and 2 (newly diagnosed with mild psoriasis: n=25; moderate/severe/very severe psoriasis: n=15). The GCM exercise elicited 37 retained responses to the prompt “An ideal treatment to manage the symptoms of my psoriasis should...” Using multidimensional scaling and cluster analysis, 5 domains of treatment importance were configured (prevention, efficacy, application characteristics, administration, and treatment preferences); the first 3 of these domains indicated the highest level of importance. For the individual statement ratings, the 4 highest rated statements were “relieve the itching and associated discomfort”, “be effective with little to no side effects”, “control the itching”, and “clear the skin and keep it clear”. The 28-item patient treatment acceptability measure was debriefed in Stage 2 participants, which refined the measure to a 20-item assessment using a 4-point verbal response scale of importance (not at all important to extremely important).

CONCLUSIONS: This study aimed to develop a measure across the psoriasis disease severity spectrum that would bolster patient and clinician communication on treatment expectations. The resulting tool has been developed in the patient voice and is representative of domains most important for managing treatment expectation.