Page 74 - JCTR-11-4

Journal of Clinical and
Translational Research Adherence and psoriasis severity in Brazil

Figure 1. Correlation matrix of psoriasis severity, satisfaction with treatment, adherence to treatment, and treatment interruption. The values in the
matrix represent the correlation coefficients between these variables, indicating the strength and direction of their relationships. Positive correlations are
highlighted in green, while negative correlations are highlighted in red, with the intensity of the color reflecting the magnitude of the correlation. The
psoriasis area severity index score is used as an indicator of psoriasis severity.

4. Discussion history of treatment discontinuation had higher PASI
scores, accounting for 5.97% of the variance. These
Adherence and persistence to pharmacotherapy are findings imply that while both adherence and treatment
critical determinants of psoriasis treatment success, interruption influence psoriasis severity, the latter has a
particularly in chronic conditions requiring long-term more pronounced impact on disease worsening.
management. High levels of adherence and persistence
are associated with better therapeutic outcomes, including The sample showed a similar representation of men
symptom control, prevention of disease progression, and and women, aligning with previous findings that psoriasis
3
improved quality of life. Conversely, poor adherence and has no sex predilection. The patient-assessed disease
frequent discontinuation can lead to suboptimal treatment severity differed from the PASI score, underscoring the
outcomes, exacerbation of disease, and increased healthcare importance of incorporating patient perceptions into
costs due to the need for more intensive interventions. assessments of both disease burden and quality of life.
21
Therefore, enhancing adherence and persistence through Integrating subjective patient-reported outcomes with
patient education, regular follow-up, and addressing objective clinical measures is essential for a comprehensive
barriers to consistent medication use is vital for achieving evaluation of therapeutic efficacy. 22
therapeutic goals and ensuring effective long-term disease Literature on treatment adherence in psoriasis is
management. heterogeneous. Our findings are consistent with those of
Our results demonstrated a relationship between Avazeh et al., who observed that among 575 psoriasis
23
psoriasis severity, as measured by the PASI, and patient patients, a significant majority (70.7%) reported low
adherence to treatment protocols. Specifically, a negative medication adherence, while 24.1% had moderate
correlation was observed between PASI scores and adherence and only 5.2% achieved high adherence.
treatment adherence, with a correlation coefficient Factors such as age, comorbidities, treatment type,
of −0.102, indicating that lower adherence is associated adverse effects, treatment satisfaction, and health literacy
with slightly higher PASI scores, though this relationship were significantly associated with medication adherence.
accounted for only 1.04% of PASI variance. Conversely, a Notably, 57.6% of participants cited forgetfulness as
positive correlation was found between PASI scores and a primary reason for non-adherence, while 54.6%
the history of treatment interruption, with a correlation discontinued treatment without consulting their doctor
coefficient of 0.2444, suggesting that patients with a due to adverse effects. 23

Volume 11 Issue 4 (2025) 68 doi: 10.36922/jctr.24.00057