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Nonadherence to systemic immune-modifying therapy in people with psoriasis during the COVID-19 pandemic: findings from a global cross-sectional survey
Nonadherence to immune-modifying therapy is a complex behaviour which, before the COVID-19 pandemic, was shown to be associated with mental health disorders in people with immune-mediated diseases. The COVID-19 pandemic has led to a rise in the global prevalence of anxiety and depression, and limite...
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Published in: | British journal of dermatology (1951) 2023-04, Vol.188 (5), p.610-617 |
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creator | Quirke-McFarlane, Sophia Weinman, John Cook, Emma S Yiu, Zenas Z N Dand, Nick Langan, Sinead M Bechman, Katie Tsakok, Teresa Mason, Kayleigh J McAteer, Helen Meynell, Freya Coker, Bolaji Vincent, Alexandra Urmston, Dominic Vesty, Amber Kelly, Jade Lancelot, Camille Moorhead, Lucy Barbosa, Ines A Bachelez, Herve Capon, Francesca Contreras, Claudia R De La Cruz, Claudia Di Meglio, Paola Gisondi, Paolo Jullien, Denis Lambert, Jo Naldi, Luigi Puig, Lluís Spuls, Phyllis Torres, Tiago Warren, Richard B Waweru, Hoseah Galloway, James B Griffiths, Christopher E M Barker, Jonathan N Norton, Sam Smith, Catherine H Mahil, Satveer K |
description | Nonadherence to immune-modifying therapy is a complex behaviour which, before the COVID-19 pandemic, was shown to be associated with mental health disorders in people with immune-mediated diseases. The COVID-19 pandemic has led to a rise in the global prevalence of anxiety and depression, and limited data exist on the association between mental health and nonadherence to immune-modifying therapy during the pandemic.
To assess the extent of and reasons underlying nonadherence to systemic immune-modifying therapy during the COVID-19 pandemic in individuals with psoriasis, and the association between mental health and nonadherence.
Online self-report surveys (PsoProtectMe), including validated screens for anxiety and depression, were completed globally during the first year of the pandemic. We assessed the association between anxiety or depression and nonadherence to systemic immune-modifying therapy using binomial logistic regression, adjusting for potential cofounders (age, sex, ethnicity, comorbidity) and country of residence.
Of 3980 participants from 77 countries, 1611 (40.5%) were prescribed a systemic immune-modifying therapy. Of these, 408 (25.3%) reported nonadherence during the pandemic, most commonly due to concerns about their immunity. In the unadjusted model, a positive anxiety screen was associated with nonadherence to systemic immune-modifying therapy [odds ratio (OR) 1.37, 95% confidence interval (CI) 1.07-1.76]. Specifically, anxiety was associated with nonadherence to targeted therapy (OR 1.41, 95% CI 1.01-1.96) but not standard systemic therapy (OR 1.16, 95% CI 0.81-1.67). In the adjusted model, although the directions of the effects remained, anxiety was not significantly associated with nonadherence to overall systemic (OR 1.20, 95% CI 0.92-1.56) or targeted (OR 1.33, 95% CI 0.94-1.89) immune-modifying therapy. A positive depression screen was not strongly associated with nonadherence to systemic immune-modifying therapy in the unadjusted (OR 1.22, 95% CI 0.94-1.57) or adjusted models (OR 1.14, 95% CI 0.87-1.49).
These data indicate substantial nonadherence to immune-modifying therapy in people with psoriasis during the pandemic, with attenuation of the association with mental health after adjusting for confounders. Future research in larger populations should further explore pandemic-specific drivers of treatment nonadherence. Clear communication of the reassuring findings from population-based research regarding immune-modifying therap |
doi_str_mv | 10.1093/bjd/ljac144 |
format | article |
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To assess the extent of and reasons underlying nonadherence to systemic immune-modifying therapy during the COVID-19 pandemic in individuals with psoriasis, and the association between mental health and nonadherence.
Online self-report surveys (PsoProtectMe), including validated screens for anxiety and depression, were completed globally during the first year of the pandemic. We assessed the association between anxiety or depression and nonadherence to systemic immune-modifying therapy using binomial logistic regression, adjusting for potential cofounders (age, sex, ethnicity, comorbidity) and country of residence.
Of 3980 participants from 77 countries, 1611 (40.5%) were prescribed a systemic immune-modifying therapy. Of these, 408 (25.3%) reported nonadherence during the pandemic, most commonly due to concerns about their immunity. In the unadjusted model, a positive anxiety screen was associated with nonadherence to systemic immune-modifying therapy [odds ratio (OR) 1.37, 95% confidence interval (CI) 1.07-1.76]. Specifically, anxiety was associated with nonadherence to targeted therapy (OR 1.41, 95% CI 1.01-1.96) but not standard systemic therapy (OR 1.16, 95% CI 0.81-1.67). In the adjusted model, although the directions of the effects remained, anxiety was not significantly associated with nonadherence to overall systemic (OR 1.20, 95% CI 0.92-1.56) or targeted (OR 1.33, 95% CI 0.94-1.89) immune-modifying therapy. A positive depression screen was not strongly associated with nonadherence to systemic immune-modifying therapy in the unadjusted (OR 1.22, 95% CI 0.94-1.57) or adjusted models (OR 1.14, 95% CI 0.87-1.49).
These data indicate substantial nonadherence to immune-modifying therapy in people with psoriasis during the pandemic, with attenuation of the association with mental health after adjusting for confounders. Future research in larger populations should further explore pandemic-specific drivers of treatment nonadherence. Clear communication of the reassuring findings from population-based research regarding immune-modifying therapy-associated adverse COVID-19 risks to people with psoriasis is essential, to optimize adherence and disease outcomes.</description><identifier>ISSN: 0007-0963</identifier><identifier>EISSN: 1365-2133</identifier><identifier>DOI: 10.1093/bjd/ljac144</identifier><identifier>PMID: 36763806</identifier><language>eng</language><publisher>England</publisher><subject>Anxiety - epidemiology ; Anxiety - psychology ; COVID-19 - epidemiology ; Cross-Sectional Studies ; Depression - epidemiology ; Humans ; Pandemics ; Psoriasis - drug therapy ; Psoriasis - epidemiology</subject><ispartof>British journal of dermatology (1951), 2023-04, Vol.188 (5), p.610-617</ispartof><rights>The Author(s) 2022. Published by Oxford University Press on behalf of British Association of Dermatologists.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c326t-500d548f3f7446e78f506609887b1d70ee209158696c56b743ac43f83174ac833</citedby><cites>FETCH-LOGICAL-c326t-500d548f3f7446e78f506609887b1d70ee209158696c56b743ac43f83174ac833</cites><orcidid>0000-0002-2845-4384 ; 0000-0003-4692-3794 ; 0000-0002-1805-6278 ; 0000-0002-2918-6481 ; 0000-0002-1831-074X ; 0000-0003-1714-9963 ; 0000-0001-9918-1144</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36763806$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Quirke-McFarlane, Sophia</creatorcontrib><creatorcontrib>Weinman, John</creatorcontrib><creatorcontrib>Cook, Emma S</creatorcontrib><creatorcontrib>Yiu, Zenas Z N</creatorcontrib><creatorcontrib>Dand, Nick</creatorcontrib><creatorcontrib>Langan, Sinead M</creatorcontrib><creatorcontrib>Bechman, Katie</creatorcontrib><creatorcontrib>Tsakok, Teresa</creatorcontrib><creatorcontrib>Mason, Kayleigh J</creatorcontrib><creatorcontrib>McAteer, Helen</creatorcontrib><creatorcontrib>Meynell, Freya</creatorcontrib><creatorcontrib>Coker, Bolaji</creatorcontrib><creatorcontrib>Vincent, Alexandra</creatorcontrib><creatorcontrib>Urmston, Dominic</creatorcontrib><creatorcontrib>Vesty, Amber</creatorcontrib><creatorcontrib>Kelly, Jade</creatorcontrib><creatorcontrib>Lancelot, Camille</creatorcontrib><creatorcontrib>Moorhead, Lucy</creatorcontrib><creatorcontrib>Barbosa, Ines A</creatorcontrib><creatorcontrib>Bachelez, Herve</creatorcontrib><creatorcontrib>Capon, Francesca</creatorcontrib><creatorcontrib>Contreras, Claudia R</creatorcontrib><creatorcontrib>De La Cruz, Claudia</creatorcontrib><creatorcontrib>Di Meglio, Paola</creatorcontrib><creatorcontrib>Gisondi, Paolo</creatorcontrib><creatorcontrib>Jullien, Denis</creatorcontrib><creatorcontrib>Lambert, Jo</creatorcontrib><creatorcontrib>Naldi, Luigi</creatorcontrib><creatorcontrib>Puig, Lluís</creatorcontrib><creatorcontrib>Spuls, Phyllis</creatorcontrib><creatorcontrib>Torres, Tiago</creatorcontrib><creatorcontrib>Warren, Richard B</creatorcontrib><creatorcontrib>Waweru, Hoseah</creatorcontrib><creatorcontrib>Galloway, James B</creatorcontrib><creatorcontrib>Griffiths, Christopher E M</creatorcontrib><creatorcontrib>Barker, Jonathan N</creatorcontrib><creatorcontrib>Norton, Sam</creatorcontrib><creatorcontrib>Smith, Catherine H</creatorcontrib><creatorcontrib>Mahil, Satveer K</creatorcontrib><creatorcontrib>PsoProtect study group</creatorcontrib><creatorcontrib>the PsoProtect study group</creatorcontrib><title>Nonadherence to systemic immune-modifying therapy in people with psoriasis during the COVID-19 pandemic: findings from a global cross-sectional survey</title><title>British journal of dermatology (1951)</title><addtitle>Br J Dermatol</addtitle><description>Nonadherence to immune-modifying therapy is a complex behaviour which, before the COVID-19 pandemic, was shown to be associated with mental health disorders in people with immune-mediated diseases. The COVID-19 pandemic has led to a rise in the global prevalence of anxiety and depression, and limited data exist on the association between mental health and nonadherence to immune-modifying therapy during the pandemic.
To assess the extent of and reasons underlying nonadherence to systemic immune-modifying therapy during the COVID-19 pandemic in individuals with psoriasis, and the association between mental health and nonadherence.
Online self-report surveys (PsoProtectMe), including validated screens for anxiety and depression, were completed globally during the first year of the pandemic. We assessed the association between anxiety or depression and nonadherence to systemic immune-modifying therapy using binomial logistic regression, adjusting for potential cofounders (age, sex, ethnicity, comorbidity) and country of residence.
Of 3980 participants from 77 countries, 1611 (40.5%) were prescribed a systemic immune-modifying therapy. Of these, 408 (25.3%) reported nonadherence during the pandemic, most commonly due to concerns about their immunity. In the unadjusted model, a positive anxiety screen was associated with nonadherence to systemic immune-modifying therapy [odds ratio (OR) 1.37, 95% confidence interval (CI) 1.07-1.76]. Specifically, anxiety was associated with nonadherence to targeted therapy (OR 1.41, 95% CI 1.01-1.96) but not standard systemic therapy (OR 1.16, 95% CI 0.81-1.67). In the adjusted model, although the directions of the effects remained, anxiety was not significantly associated with nonadherence to overall systemic (OR 1.20, 95% CI 0.92-1.56) or targeted (OR 1.33, 95% CI 0.94-1.89) immune-modifying therapy. A positive depression screen was not strongly associated with nonadherence to systemic immune-modifying therapy in the unadjusted (OR 1.22, 95% CI 0.94-1.57) or adjusted models (OR 1.14, 95% CI 0.87-1.49).
These data indicate substantial nonadherence to immune-modifying therapy in people with psoriasis during the pandemic, with attenuation of the association with mental health after adjusting for confounders. Future research in larger populations should further explore pandemic-specific drivers of treatment nonadherence. Clear communication of the reassuring findings from population-based research regarding immune-modifying therapy-associated adverse COVID-19 risks to people with psoriasis is essential, to optimize adherence and disease outcomes.</description><subject>Anxiety - epidemiology</subject><subject>Anxiety - psychology</subject><subject>COVID-19 - epidemiology</subject><subject>Cross-Sectional Studies</subject><subject>Depression - epidemiology</subject><subject>Humans</subject><subject>Pandemics</subject><subject>Psoriasis - drug therapy</subject><subject>Psoriasis - epidemiology</subject><issn>0007-0963</issn><issn>1365-2133</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNo9kUFP3DAQhS3Uqiy0J-7VHCuhwDhO7KS3aqGAhMql7TVy7DF4lcSpnYDyR_p7my3bnubwPn16msfYGccLjrW4bHf2sttpw4viiG24kGWWcyHesA0iqgxrKY7ZSUo7RC6wxHfsWEglRYVyw35_C4O2TxRpMARTgLSkiXpvwPf9PFDWB-vd4odHmFZKjwv4AUYKY0fw4qcnGFOIXiefwM7xwMH24efdVcZrGPVg97rP4Pxg1ziBi6EHDY9daHUHJoaUskRm8muTDtIcn2l5z9463SX6cLin7MfX6-_b2-z-4eZu--U-MyKXU1Yi2rKonHCqKCSpypUoJdZVpVpuFRLlWPOykrU0pWxVIbQphKsEV4U2lRCn7NOrd4zh10xpanqfDHWdHijMqcmVKiXPpdyj56_o38aRXDNG3-u4NByb_RDNOkRzGGKlPx7Ec9uT_c_--7z4A3dchl8</recordid><startdate>20230420</startdate><enddate>20230420</enddate><creator>Quirke-McFarlane, Sophia</creator><creator>Weinman, John</creator><creator>Cook, Emma S</creator><creator>Yiu, Zenas Z N</creator><creator>Dand, Nick</creator><creator>Langan, Sinead M</creator><creator>Bechman, Katie</creator><creator>Tsakok, Teresa</creator><creator>Mason, Kayleigh J</creator><creator>McAteer, Helen</creator><creator>Meynell, Freya</creator><creator>Coker, Bolaji</creator><creator>Vincent, Alexandra</creator><creator>Urmston, Dominic</creator><creator>Vesty, Amber</creator><creator>Kelly, Jade</creator><creator>Lancelot, Camille</creator><creator>Moorhead, Lucy</creator><creator>Barbosa, Ines A</creator><creator>Bachelez, Herve</creator><creator>Capon, Francesca</creator><creator>Contreras, Claudia R</creator><creator>De La Cruz, Claudia</creator><creator>Di Meglio, Paola</creator><creator>Gisondi, Paolo</creator><creator>Jullien, Denis</creator><creator>Lambert, Jo</creator><creator>Naldi, Luigi</creator><creator>Puig, Lluís</creator><creator>Spuls, Phyllis</creator><creator>Torres, Tiago</creator><creator>Warren, Richard B</creator><creator>Waweru, Hoseah</creator><creator>Galloway, James B</creator><creator>Griffiths, Christopher E M</creator><creator>Barker, Jonathan N</creator><creator>Norton, Sam</creator><creator>Smith, Catherine H</creator><creator>Mahil, Satveer K</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2845-4384</orcidid><orcidid>https://orcid.org/0000-0003-4692-3794</orcidid><orcidid>https://orcid.org/0000-0002-1805-6278</orcidid><orcidid>https://orcid.org/0000-0002-2918-6481</orcidid><orcidid>https://orcid.org/0000-0002-1831-074X</orcidid><orcidid>https://orcid.org/0000-0003-1714-9963</orcidid><orcidid>https://orcid.org/0000-0001-9918-1144</orcidid></search><sort><creationdate>20230420</creationdate><title>Nonadherence to systemic immune-modifying therapy in people with psoriasis during the COVID-19 pandemic: findings from a global cross-sectional survey</title><author>Quirke-McFarlane, Sophia ; Weinman, John ; Cook, Emma S ; Yiu, Zenas Z N ; Dand, Nick ; Langan, Sinead M ; Bechman, Katie ; Tsakok, Teresa ; Mason, Kayleigh J ; McAteer, Helen ; Meynell, Freya ; Coker, Bolaji ; Vincent, Alexandra ; Urmston, Dominic ; Vesty, Amber ; Kelly, Jade ; Lancelot, Camille ; Moorhead, Lucy ; Barbosa, Ines A ; Bachelez, Herve ; Capon, Francesca ; Contreras, Claudia R ; De La Cruz, Claudia ; Di Meglio, Paola ; Gisondi, Paolo ; Jullien, Denis ; Lambert, Jo ; Naldi, Luigi ; Puig, Lluís ; Spuls, Phyllis ; Torres, Tiago ; Warren, Richard B ; Waweru, Hoseah ; Galloway, James B ; Griffiths, Christopher E M ; Barker, Jonathan N ; Norton, Sam ; Smith, Catherine H ; Mahil, Satveer K</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-500d548f3f7446e78f506609887b1d70ee209158696c56b743ac43f83174ac833</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Anxiety - epidemiology</topic><topic>Anxiety - psychology</topic><topic>COVID-19 - epidemiology</topic><topic>Cross-Sectional Studies</topic><topic>Depression - epidemiology</topic><topic>Humans</topic><topic>Pandemics</topic><topic>Psoriasis - drug therapy</topic><topic>Psoriasis - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Quirke-McFarlane, Sophia</creatorcontrib><creatorcontrib>Weinman, John</creatorcontrib><creatorcontrib>Cook, Emma S</creatorcontrib><creatorcontrib>Yiu, Zenas Z N</creatorcontrib><creatorcontrib>Dand, Nick</creatorcontrib><creatorcontrib>Langan, Sinead M</creatorcontrib><creatorcontrib>Bechman, Katie</creatorcontrib><creatorcontrib>Tsakok, Teresa</creatorcontrib><creatorcontrib>Mason, Kayleigh J</creatorcontrib><creatorcontrib>McAteer, Helen</creatorcontrib><creatorcontrib>Meynell, Freya</creatorcontrib><creatorcontrib>Coker, Bolaji</creatorcontrib><creatorcontrib>Vincent, Alexandra</creatorcontrib><creatorcontrib>Urmston, Dominic</creatorcontrib><creatorcontrib>Vesty, Amber</creatorcontrib><creatorcontrib>Kelly, Jade</creatorcontrib><creatorcontrib>Lancelot, Camille</creatorcontrib><creatorcontrib>Moorhead, Lucy</creatorcontrib><creatorcontrib>Barbosa, Ines A</creatorcontrib><creatorcontrib>Bachelez, Herve</creatorcontrib><creatorcontrib>Capon, Francesca</creatorcontrib><creatorcontrib>Contreras, Claudia R</creatorcontrib><creatorcontrib>De La Cruz, Claudia</creatorcontrib><creatorcontrib>Di Meglio, Paola</creatorcontrib><creatorcontrib>Gisondi, Paolo</creatorcontrib><creatorcontrib>Jullien, Denis</creatorcontrib><creatorcontrib>Lambert, Jo</creatorcontrib><creatorcontrib>Naldi, Luigi</creatorcontrib><creatorcontrib>Puig, Lluís</creatorcontrib><creatorcontrib>Spuls, Phyllis</creatorcontrib><creatorcontrib>Torres, Tiago</creatorcontrib><creatorcontrib>Warren, Richard B</creatorcontrib><creatorcontrib>Waweru, Hoseah</creatorcontrib><creatorcontrib>Galloway, James B</creatorcontrib><creatorcontrib>Griffiths, Christopher E M</creatorcontrib><creatorcontrib>Barker, Jonathan N</creatorcontrib><creatorcontrib>Norton, Sam</creatorcontrib><creatorcontrib>Smith, Catherine H</creatorcontrib><creatorcontrib>Mahil, Satveer K</creatorcontrib><creatorcontrib>PsoProtect study group</creatorcontrib><creatorcontrib>the PsoProtect study group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of dermatology (1951)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Quirke-McFarlane, Sophia</au><au>Weinman, John</au><au>Cook, Emma S</au><au>Yiu, Zenas Z N</au><au>Dand, Nick</au><au>Langan, Sinead M</au><au>Bechman, Katie</au><au>Tsakok, Teresa</au><au>Mason, Kayleigh J</au><au>McAteer, Helen</au><au>Meynell, Freya</au><au>Coker, Bolaji</au><au>Vincent, Alexandra</au><au>Urmston, Dominic</au><au>Vesty, Amber</au><au>Kelly, Jade</au><au>Lancelot, Camille</au><au>Moorhead, Lucy</au><au>Barbosa, Ines A</au><au>Bachelez, Herve</au><au>Capon, Francesca</au><au>Contreras, Claudia R</au><au>De La Cruz, Claudia</au><au>Di Meglio, Paola</au><au>Gisondi, Paolo</au><au>Jullien, Denis</au><au>Lambert, Jo</au><au>Naldi, Luigi</au><au>Puig, Lluís</au><au>Spuls, Phyllis</au><au>Torres, Tiago</au><au>Warren, Richard B</au><au>Waweru, Hoseah</au><au>Galloway, James B</au><au>Griffiths, Christopher E M</au><au>Barker, Jonathan N</au><au>Norton, Sam</au><au>Smith, Catherine H</au><au>Mahil, Satveer K</au><aucorp>PsoProtect study group</aucorp><aucorp>the PsoProtect study group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Nonadherence to systemic immune-modifying therapy in people with psoriasis during the COVID-19 pandemic: findings from a global cross-sectional survey</atitle><jtitle>British journal of dermatology (1951)</jtitle><addtitle>Br J Dermatol</addtitle><date>2023-04-20</date><risdate>2023</risdate><volume>188</volume><issue>5</issue><spage>610</spage><epage>617</epage><pages>610-617</pages><issn>0007-0963</issn><eissn>1365-2133</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>Nonadherence to immune-modifying therapy is a complex behaviour which, before the COVID-19 pandemic, was shown to be associated with mental health disorders in people with immune-mediated diseases. The COVID-19 pandemic has led to a rise in the global prevalence of anxiety and depression, and limited data exist on the association between mental health and nonadherence to immune-modifying therapy during the pandemic.
To assess the extent of and reasons underlying nonadherence to systemic immune-modifying therapy during the COVID-19 pandemic in individuals with psoriasis, and the association between mental health and nonadherence.
Online self-report surveys (PsoProtectMe), including validated screens for anxiety and depression, were completed globally during the first year of the pandemic. We assessed the association between anxiety or depression and nonadherence to systemic immune-modifying therapy using binomial logistic regression, adjusting for potential cofounders (age, sex, ethnicity, comorbidity) and country of residence.
Of 3980 participants from 77 countries, 1611 (40.5%) were prescribed a systemic immune-modifying therapy. Of these, 408 (25.3%) reported nonadherence during the pandemic, most commonly due to concerns about their immunity. In the unadjusted model, a positive anxiety screen was associated with nonadherence to systemic immune-modifying therapy [odds ratio (OR) 1.37, 95% confidence interval (CI) 1.07-1.76]. Specifically, anxiety was associated with nonadherence to targeted therapy (OR 1.41, 95% CI 1.01-1.96) but not standard systemic therapy (OR 1.16, 95% CI 0.81-1.67). In the adjusted model, although the directions of the effects remained, anxiety was not significantly associated with nonadherence to overall systemic (OR 1.20, 95% CI 0.92-1.56) or targeted (OR 1.33, 95% CI 0.94-1.89) immune-modifying therapy. A positive depression screen was not strongly associated with nonadherence to systemic immune-modifying therapy in the unadjusted (OR 1.22, 95% CI 0.94-1.57) or adjusted models (OR 1.14, 95% CI 0.87-1.49).
These data indicate substantial nonadherence to immune-modifying therapy in people with psoriasis during the pandemic, with attenuation of the association with mental health after adjusting for confounders. Future research in larger populations should further explore pandemic-specific drivers of treatment nonadherence. Clear communication of the reassuring findings from population-based research regarding immune-modifying therapy-associated adverse COVID-19 risks to people with psoriasis is essential, to optimize adherence and disease outcomes.</abstract><cop>England</cop><pmid>36763806</pmid><doi>10.1093/bjd/ljac144</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-2845-4384</orcidid><orcidid>https://orcid.org/0000-0003-4692-3794</orcidid><orcidid>https://orcid.org/0000-0002-1805-6278</orcidid><orcidid>https://orcid.org/0000-0002-2918-6481</orcidid><orcidid>https://orcid.org/0000-0002-1831-074X</orcidid><orcidid>https://orcid.org/0000-0003-1714-9963</orcidid><orcidid>https://orcid.org/0000-0001-9918-1144</orcidid><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0007-0963 |
ispartof | British journal of dermatology (1951), 2023-04, Vol.188 (5), p.610-617 |
issn | 0007-0963 1365-2133 |
language | eng |
recordid | cdi_proquest_miscellaneous_2775612663 |
source | Oxford Journals |
subjects | Anxiety - epidemiology Anxiety - psychology COVID-19 - epidemiology Cross-Sectional Studies Depression - epidemiology Humans Pandemics Psoriasis - drug therapy Psoriasis - epidemiology |
title | Nonadherence to systemic immune-modifying therapy in people with psoriasis during the COVID-19 pandemic: findings from a global cross-sectional survey |
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