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Title: Medication adherence in psoriasis : interventions and outcomes
Author: Abdalgader, Ghazala Matoug Mohamed
Awarding Body: University of Leeds
Current Institution: University of Leeds
Date of Award: 2012
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Psoriasis is one of the most important inflammatory cutaneous diseases with a profound effect on a patient's quality of life. Treatment regimens are beneficial but only if patients adhere to them. Therefore, enhancing medication adherence is a major issue in psoriasis management outcomes. Available literature shows that adherence to medication in psoriasis is poor, but there have been no controlled studies aiming at improving it. I have investigated various aspects of medication adherence. Firstly, I assessed the impact of a simple educat ion consultat ion by dermatology specialist nurses. This randomized controlled study did not show any statist ically significant difference in the adherence rates between the control and the education groups. Mean overall adherence rates in the control and the education groups were 72.8 % and 74.9 % respectively As adherence to treatment is patient behaviour, I secondly applied graded behavioural interventions that tackle forgetting behaviour of taking medication. We randomly reminded one group of patients about the critical importance of adherence and in a second group we similarly reminded them but also helped them to make adherence action plans to fo llow (using implementation intention theory). Controlling these two groups with a group of patients with no intervention did not show significant improvement in adherence rates. The mean unadjusted overall adherence rates were 72.8%, 76.7% and 72.8% in the control group, the reminding group and the group of reminding with action planning, respectively. Generally, none of the intervention strategies we used had any impact on adherence to medication in psoriasis patients. This may be attributed to the fact that the adherence to medication in this group of pat ients is noticeably high. Perhaps multidisciplinary approaches involving both educational and behavioural interventions would give better results. Finally, I compared the results of this study with the results of a similar published study to investigate longitudinal changes in adherence behaviour. The two groups of patients were different in a number of aspects, but adherence had improved markedly over time.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available