Beliefs About Medicines in Patients with Psoriasis Treated with Methotrexate or Biologics: A Cross-sectional Survey Study
Marisol E. Otero, Juul M.P.A. van den Reek, Peter C.M. van de Kerkhof, Jorre S. Mertens, Marieke M.B. Seyger, Wietske Kievit, Elke M.G.J. de Jong
Methotrexate (MTX) and biologics are frequently used treatments for psoriasis. Exploring patients’ beliefs about their treatment may help to elucidate patients’ attitudes towards these therapies. A cross-sectional survey was conducted using the Beliefs about Medicines Questionnaire-Specific (BMQ-Specific) in patients treated with methotrexate or biologics. BMQ-Specific scores (Necessity and Concerns scales) were calculated and patients were classified as “accepting”, “indifferent”, “ambivalent” or “sceptical” towards their treatment. Biologics users scored higher on the Necessity scale than did methotrexate users. Both groups had lower Concerns scores than Necessity scores. A high Necessity scale was associated with a low Psoriasis Area and Severity Index score in both groups and long treatment duration in the methotrexate group. Although this study cannot make a direct comparison, it was observed that most patients on biologics could be classified as “accepting” (59%), and most patients on MTX could be classified as “indifferent” (47%). In conclusion, the BMQ-Specific is useful to identify patients with a sceptical, ambivalent or indifferent profile. These profiles may negatively influence patient’s attitude towards their medication.
Methotrexate and biologics are the most-used systemic treatments for psoriasis. This study describes the beliefs (necessity to use, and concerns about these treatments) of patients using these treatments, and factors associated with these beliefs. Patients using biologics were found to have a higher necessity to use the treatment than those using methotrexate. A high necessity was associated with a low Psoriasis Area and Severity Index in both treatment groups, and with longer treatment duration in the methotrexate group. Most patients using biologics could be classified as “accepting” the treatment, and most patients using methotrexate as “indifferent” to the treatment. Identifying patients with a sceptical, ambivalent or indifferent profile could be useful, because these profiles could negatively influence patient’s attitude towards their medication.