Does the Vehicle Matter? Real-World Evidence on Adherence to Topical Treatment in Psoriasis
Ana Teixeira,
Maribel Teixeira,
Vera Almeida,
Rita Gaio,
Tiago Torres,
Sofia Magina,
Cátia Cunha,
José M. Sousa Lobo,
Isabel F. Almeida
Affiliations
Ana Teixeira
Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde (IINFACTS), Instituto Universitário de Ciências da Saúde, CESPU, 4585-116 Gandra, Portugal
Maribel Teixeira
Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde (IINFACTS), Instituto Universitário de Ciências da Saúde, CESPU, 4585-116 Gandra, Portugal
Vera Almeida
Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde (IINFACTS), Instituto Universitário de Ciências da Saúde, CESPU, 4585-116 Gandra, Portugal
Rita Gaio
Centro de Matemática, Departamento de Matemática, Faculdade de Ciências, Universidade do Porto, 4169-007 Porto, Portugal
Tiago Torres
Serviço de Dermatologia, Centro Hospitalar do Porto, Hospital de Santo António, 4099-001 Porto, Portugal
Sofia Magina
Serviço de Dermatologia, Centro Hospitalar de São João, Departamento de Farmacologia e Terapêutica, Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
Cátia Cunha
Serviços Farmacêuticos, Centro Hospitalar do Tâmega e Sousa, 4564-007 Penafiel, Portugal
José M. Sousa Lobo
Laboratório de Tecnologia Farmacêutica, MedTech, UCIBIO-REQUIMTE, Departamento de Ciências do Medicamento, Faculdade de Farmácia, Universidade do Porto, 4050-313 Porto, Portugal
Isabel F. Almeida
Laboratório de Tecnologia Farmacêutica, MedTech, UCIBIO-REQUIMTE, Departamento de Ciências do Medicamento, Faculdade de Farmácia, Universidade do Porto, 4050-313 Porto, Portugal
The influence of the vehicle in topical treatment adherence remains to be elucidated. The aim of this study is to analyze the influence of the pharmaceutical dosage form on adherence to topical treatment in psoriasis patients, taking into consideration the mechanical features. The adherence was evaluated in a sample of 102 psoriasis patients, followed for approximately 45 days. Adherence was calculated with a new combined methodology using a log and medication weights. The effect of the group formulation was evaluated using logistic regression models. A complex effect of the vehicle on adherence was found, mediated by the affected area. The adherence was significantly higher for patients applying gels and creams than for those using ointments, whenever the body area affected was extensive. The opposite was found when the affected area was small. Mechanical properties can partially explain the findings since gels and creams may be easier to apply. Patient beliefs and preferences regarding vehicles and their sensory attributes might also explain the results. It is noteworthy that adherence was strikingly low, with more than 75% non-adherent patients. This real-world evidence provides an insight for pharmaceutical industries and guidance for treatment prescription by physicians aiming to address the public health emergency of treatment non-adherence.
