Non-adherence to psoriasis medication as an outcome of limited coping resources and conflicting goals: findings from a qualitative interview study with people with psoriasis: findings from a qualitative interview study with people with psoriasis

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Abstract

BACKGROUND: Medication non-adherence is known to limit the effectiveness of available therapies, however little is known specifically about medication adherence in people with psoriasis. Medicines self-management can feel onerous to those with dermatological conditions due to the nature of therapies prescribed and many individuals with psoriasis experience additional challenges such as physical and psychological comorbidities that place significant additional demands on individuals and may undermine adherence. Viewing non-adherence to medication as an outcome of limited personal coping resources and conflicting goals may help explain medication non-adherence OBJECTIVE: To explore individuals' perspectives of their psoriasis, medication and its management.

METHODS: Twenty people with psoriasis were recruited from community samples in England and interviewed in-depth about their perceptions of their psoriasis, medication, and adherence to medication and self-management advice. Data were analysed using Framework Analysis.

RESULTS: Participants reported that adhering to recommended treatment regimens conflicted with the management of the physical and psychological demands of living with psoriasis. Medication usage was viewed as a source of unresolved emotional distress and, for some, resulted in poor self-reported adherence which included medication overuse, underuse and rejection of prescribed therapies. Perceived lack of engagement by clinicians with participants' self-management difficulties was viewed as an additional source of stress and distress.

CONCLUSIONS: Adhering to medication in psoriasis can be an additional source of considerable emotional distress. We interpreted some episodes of non-adherence to psoriasis medication as rational attempts by individuals to minimise distress and to gain control over their life. This article is protected by copyright. All rights reserved.

Bibliographical metadata

Original languageEnglish
Pages (from-to)667-676
JournalBritish Journal of Dermatology
Volume176
Early online date24 Sep 2016
DOIs
Publication statusPublished - Mar 2017

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