Patient preferences for psoriasis treatments: process characteristics can outweigh outcome attributes

Arch Dermatol. 2011 Nov;147(11):1285-94. doi: 10.1001/archdermatol.2011.309.


Objectives: To assess patients' preferences for psoriasis treatments and to identify the effect of sociodemographic and socioeconomic characteristics on these preferences.

Design: A computer-based conjoint analysis experiment was conducted to analyze the preferences of individuals with moderate or severe psoriasis for outcome attributes (probability, magnitude, and duration of benefit, as well as probability, severity, and reversibility of adverse effects) and process attributes (treatment location, frequency, duration, delivery method, and individual cost) of psoriasis treatments. Relative importance scores (RISs) for each attribute were calculated. The effect of sociodemographic (age, sex, and marital status) and socioeconomic (income and employment) characteristics and Psoriasis Area and Severity Index and Dermatology Life Quality Index scores on preferences was assessed using analysis of variance, post hoc testing, and multivariate regression analysis.

Setting: Outpatient dermatology clinic at a German university medical center.

Participants: Patients with moderate or severe psoriasis (N = 163).

Main outcome measure: Relative importance scores for treatment attributes.

Results: The attribute considered to be most important in patients' preferences for psoriasis treatments was treatment location (RIS, 26.76), followed by probability of benefit (RIS, 23.77) and method of delivery (RIS, 23.49). The RISs for all process attributes were higher than for adverse effect-related attributes. Older individuals (≥65 years) were less concerned about the probability of benefit (β = -0.24; P = .005) compared with younger individuals.

Conclusions: When choosing among treatment options, individuals with psoriasis appear to be willing to accept treatment-related adverse effects to obtain process attributes compatible with their personal and professional life. Incorporating preferences in shared decision making may facilitate treatment adherence and optimize outcome.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Decision Making
  • Female
  • Germany
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Outcome Assessment, Health Care / methods*
  • Patient Compliance*
  • Patient Participation
  • Patient Preference*
  • Psoriasis / pathology
  • Psoriasis / therapy*
  • Regression Analysis
  • Severity of Illness Index
  • Socioeconomic Factors
  • Software
  • Young Adult