Development and Validation of a Novel Questionnaire for Adherence with Topical Treatments in Psoriasis (QATOP)

• Published in: American journal of clinical dermatology Vol. 18; no. 4; pp. 571 - 581
• Main Authors: Teixeira, Ana, Oliveira, Carolina, Teixeira, Maribel, Rita Gaio, A., Lobo, José Manuel Sousa, de Almeida, Isabel Filipa Martins, Almeida, Vera
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-08-2017; Springer Nature B.V
• Subjects: Administration, Cutaneous; Adult; Dermatologic Agents - administration & dosage; Dermatology; Disease management; Drug dosages; Drug stores; Electronic monitoring; Female; Humans; Male; Medication Adherence; Medicine; Medicine & Public Health; Middle Aged; Original Research Article; Patients; Pharmacology/Toxicology; Pharmacotherapy; Pilot Projects; Psoriasis; Psoriasis - drug therapy; Questionnaires; Reproducibility of Results; Skin diseases; Surveys and Questionnaires; Validity; Topical Treatment; Calcipotriol; Psoriasis; Tazarotene; Psoriasis Patient
• ISSN: 1175-0561; 1179-1888
• DOI: 10.1007/s40257-017-0272-2

Background
Self-report measures are the most used methodologies for the evaluation of adherence to psoriasis topical treatment, although currently there is no standard questionnaire for this purpose.
Objective
The present study aimed at developing a novel questionnaire (Questionnaire for Adherence to TOPical treatment [QATOP]) for the assessment of adherence to topical treatment in psoriasis.
Methods
A questionnaire containing nine items organized into two parts (part 1: current patient treatment; part 2: adherence to treatment, amount used, and treatment-associated variables) was developed, supported by a systematic literature review, qualitative patient focus interviews, and expert-group input. Its content validity was determined by a pilot study of six patients. Adherence to topical treatment was then assessed in 35 patients with psoriasis, after 45 days of treatment, using the QATOP and a medication log. Associations between different items of the QATOP and the log were investigated.
Results
Adherence results were 63.5 ± 29.2% for the log and 60.9 ± 24.4% for the QATOP, and were strongly correlated (
R
 = 0.819,
p
 < 0.001). Distinct posologic regimens were reported by patients, which, in some cases, were not the usual doses. Patients also reported using doses of medicine on each application that were markedly lower than required.
Conclusion
The QATOP is a valid and reliable self-report measure of adherence to topical treatment in patients with psoriasis. The use of this standard questionnaire could improve the methodological quality of adherence studies. Improvement of the clarity of posologic instructions is clearly urgently needed.