A smartphone application supporting patients with psoriasis improves adherence to topical treatment: A randomised controlled trial

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BACKGROUND: Adherence to topical psoriasis treatments is low which leads to unsatisfactory treatment results. Smartphone applications (apps) for patient support exist, but their potential to improve adherence has not been systematically evaluated.

OBJECTIVE: To evaluate whether a study-specific app improves adherence and reduces psoriasis symptoms compared to standard treatment.

METHODS: We conducted a randomized controlled trial. Patients received once-daily medication (calcipotriol/betamethasone dipropionate (Cal/BD) cutaneous foam) and were randomized to no app (n = 66) or app intervention (n=68) groups. 122 patients (91%) completed the 22-week follow-up.

PRIMARY OUTCOME: Adherence was defined as medication applied ≥ 80% of days during the treatment period and assessed by a chip integrated into the medication dispenser.

SECONDARY OUTCOMES: Psoriasis severity was measured by the Lattice System Physician's Global Assessment (LS-PGA), and quality of life was measured by Dermatology Life Quality Index (DLQI) scales at all visits.

RESULTS: Intention to treat analyses using regression was performed.

PRIMARY OUTCOME: more patients in the intervention group were adherent to Cal/BD cutaneous foam compared to patients in the non-intervention group at week four (65% vs. 38%, P = 0.004).

SECONDARY OUTCOMES: the intervention group showed a greater LS-PGA reduction compared to the non-intervention group at week 4 (mean 1.86 vs. 1.46, P = 0.047). A similar effect was seen at weeks 8 and 26, though it did not reach statistical significance.

CONCLUSION: This RCT demonstrates that the app improved short term adherence to Cal/BD cutaneous foam treatment and psoriasis severity. This article is protected by copyright. All rights reserved.

TidsskriftBritish Journal of Dermatology
Sidetal (fra-til)1062-1071
StatusUdgivet - 14 apr. 2018

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