Patient-reported outcomes in topical field treatment of actinic keratosis in Swedish and Danish patients

TY - JOUR

T1 - Patient-reported outcomes in topical field treatment of actinic keratosis in Swedish and Danish patients

AU - Norrlid, Hanna

AU - Norlin, Jenny M.

AU - Holmstrup, Heidi

AU - Malmberg, Irena

AU - Sartorius, Karin

AU - Thormann, Henrik

AU - Jemec, Gregor B.E.

AU - Ragnarson Tennvall, Gunnel

PY - 2018

Y1 - 2018

N2 - Topical treatments in dermatology can be long, complex and lead to nonadherence and nonpersistence to prescribed treatment. Clinical efficacy observed in randomized clinical trials (RCT) may therefore be reduced in real-world clinical practice. The objective of this study was to analyze patient-reported treatment adherence, treatment satisfaction and health-related quality of life (HRQoL) with topical treatments of actinic keratosis (AK) in routine clinical practice in Denmark and Sweden. Adult patients prescribed field-directed topical AK treatments with diclofenac gel, imiquimod or ingenol mebutate per routine clinical practice were eligible for the observational RAPID-ACT study. Data were collected through physician and patient questionnaires that included validated instruments to measure treatment satisfaction (TSQM-9), treatment adherence (MMAS) and HRQoL (EQ-5D-5L, EQ-VAS, AKQoL). In total, 446 patients from Denmark and Sweden were included. Ingenol mebutate patients reported a higher satisfaction with treatment effectiveness compared to patients treated with diclofenac (p =.006) while no other differences in treatment satisfaction could be determined. Treatment adherence was generally high, but higher for ingenol mebutate compared to both diclofenac (p <.001) and imiquimod (p =.007), possibly due to shorter treatment duration. No differences in improved HRQoL were found. More research is needed about the link between treatment adherence and real-world effectiveness.

AB - Topical treatments in dermatology can be long, complex and lead to nonadherence and nonpersistence to prescribed treatment. Clinical efficacy observed in randomized clinical trials (RCT) may therefore be reduced in real-world clinical practice. The objective of this study was to analyze patient-reported treatment adherence, treatment satisfaction and health-related quality of life (HRQoL) with topical treatments of actinic keratosis (AK) in routine clinical practice in Denmark and Sweden. Adult patients prescribed field-directed topical AK treatments with diclofenac gel, imiquimod or ingenol mebutate per routine clinical practice were eligible for the observational RAPID-ACT study. Data were collected through physician and patient questionnaires that included validated instruments to measure treatment satisfaction (TSQM-9), treatment adherence (MMAS) and HRQoL (EQ-5D-5L, EQ-VAS, AKQoL). In total, 446 patients from Denmark and Sweden were included. Ingenol mebutate patients reported a higher satisfaction with treatment effectiveness compared to patients treated with diclofenac (p =.006) while no other differences in treatment satisfaction could be determined. Treatment adherence was generally high, but higher for ingenol mebutate compared to both diclofenac (p <.001) and imiquimod (p =.007), possibly due to shorter treatment duration. No differences in improved HRQoL were found. More research is needed about the link between treatment adherence and real-world effectiveness.

KW - Actinic keratosis

KW - field treatment

KW - observational study

KW - patient-reported outcomes

U2 - 10.1080/09546634.2017.1329514

DO - 10.1080/09546634.2017.1329514

M3 - Journal article

C2 - 28658998

AN - SCOPUS:85021682287

SN - 0954-6634

VL - 29

SP - 68

EP - 73

JO - Journal of Dermatological Treatment

JF - Journal of Dermatological Treatment

IS - 1

ER -