Patient profiling

Dr Anthony Bewley

Who is your patient and what do they want to hear?

• What are your patient’s ideas, concerns, expectations (ICE)?

• How much do they already know about their psoriasis?

• Is your patient more concerned about appearance, itching or the inconvenience of applying treatments?

• What do they expect from their treatment and are they likely to adhere to the treatment regimen?

• Given limited consultation time, being able to profile your patient should improve the quality of consultations as well as making that time more effective

• Understanding that your patient’s profile may change over time will enable you to tailor their management accordingly

Large, multinational study to help understand different patient types who might benefit from individualised interventions

Identifying patients who are in need of additional support

Countries participating in the study

Research insights: study design

UK FR DE ES IT US CA Tot

608 571 488 577 358 609 611 3822

Stage 1 – Qualitative

• Ethnographic study of 56 patients with psoriasis

• 42 respondents studied for 1 day

• 14 respondents studied for 2 days

• Countries: UK, France, Germany, Italy, Spain, USA, Canada

• Online methodology, 40 minutes

• 3822 patients with psoriasis*

• Markets:

• Patient criteria

• 18 years old or over

• Suffer from psoriasis and/or psoriatic arthritis

Qualitative stage guided development of the quantitative questionnaire and sample

Stage 2 – Quantitative

Stage 1 – Qualitative

*Includes the 1884 patients currently using prescription treatments for psoriasis that are reported in Bewley et al. J Eur Acad Dermatol Venereol 2014;28:763–770

Profiles are based on key intrinsic, behavioural and attitudinal characteristics

• Patient history with psoriasis

• Burden of disease/treatment (Quality of Life; QoL)

Intrinsic characteristics Differentiating behaviours

Differentiating attitudes

◦ Treatment choice

◦ Frequency of HCP visits

◦ QoL impact

◦ Satisfaction with current medication

◦ Receptivity to new treatments

◦ Trust in HCPs

Research insights: understanding patients

Self-manager40%

Why me?28%

Help me16%

Activelyengaged16%

High

High

Low

Low

Burden of disease

Engagement with treatment

Four patient profiles developed

Why me?

40%

16%28%

Self-manager Actively engaged

16%

Help me

The four segments all have distinct problems with prescription topicals

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Self-manager

Irregular treatment (mix

and match/fire fighting)

caused by a fear of side

effects and an unmet

need for more specific

treatments

Actively engaged

The burden of treatment

is high (time, yuckiness),

but due to satisfaction

with efficacy, PTs are

used compliantly

“I must improve my condition,

so compliance is essential.” “I know cortisone creams help –

but I use them only sometimes.”

“There are no creams that help,

so why bother then?”

“Creams are creams, a waste of

time – I want real medicine.”

LOW DISEASE IMPACT HIGH DISEASE IMPACT

Why me?

Dropped out after a

frustrating experience

of trial-and-error with

PTs

Help me

Deep disappointment

with efficacy of PTs,

therefore not considering

them as proper medical

treatment

PTs are still a compromiseAmong PTs, there are not enough choices

Overall low involvement with medicine Given up on PTs and the HCS

HCS, healthcare system; PT, psoriasis treatments

Profile: Self-manager

Self-manager

40%

• Tend to have the most positive outlook on life• Psoriasis has least impact on quality of life• Not as likely to be current users of prescription medicine;

would avoid using treatments unless necessary• Least receptive to new treatments• Refer to psoriasis information least frequently• 72% have mild psoriasis

Why me?

28%

• Psoriasis not as severe as ‘Help me’ group;

however, not coping that well with psoriasis

• 50% use prescription medicine; 33% use

non-prescription medicine

• Not as satisfied with topicals; would try to avoid

prescription medicine unless necessary

• Least trusting of their HCPs

• Least adherent segment (41%)

• 53% have moderate psoriasis; 35% mild

Profile: Why me?

Profile: Help me

Help me

16%

• Tend to have the most negative outlook

• Highest percentage of body affected by psoriasis

• Psoriasis has highest impact on quality of life

• Tend not to have a good relationship with their HCP

• Most receptive to new treatments

• Refer to psoriasis information the most frequently

• 57% have moderate psoriasis; 32% severe

Profile: Actively engaged

Actively engaged

16%

• 40% use prescription medicine and 40% use

non-prescription medicine

• Have the most positive relationship with their HCP

• Tend to trust their HCP the most

• Tend to have a good level of satisfaction of topicals

• The most adherent segment (54%)

• 56% have moderate psoriasis; 33% mild

PROFILING YOUR PATIENTS

Interactive session

Dr Yi Zhao

Table 10

Professor Xibao Zhang

Table 9

Dr Niranjan Ariyasinghe

Tables 3 & 4

Dr Masatoshi Abe

Table 6

Dr Anwar Al Hammadi

Table 5

Your facilitators

Professor Min Zheng

Tables 7 & 8

Professor Sameer Zimmo*

Tables 1 & 2

*Global faculty member

Answer key questions about your patient to assist in profiling

• Burden of disease

• Engagement with treatment

Help meSelf-manager Actively engagedWhy me?

Questions about burden of disease

Psoriasis disease impact

Psoriasis stops you from doing everyday tasks…

You feel unhappy about your skin…

Your psoriasis affects your relationships with people…

Your psoriasis affects your sleep patterns…

Your psoriasis affects your confidence…

Your psoriasis stops you from socialising, going out or playing sports…

Your psoriasis flares…

Your psoriasis is itchy…

OVERALL your psoriasis affects your quality of life…

Questions about engagement with treatment

Patient’s engagement with treatment

Your treatment makes a difference to your skin

You like your treatments

You follow the treatment regime recommended to you by your HCP

Your lifestyle doesn’t interfere with your regime

Treatment really works for your psoriasis

You understand how using your treatment helps you

You like going to see your doctor/nurse/HCP

You have time to use your treatments

OVERALL you are satisfied and engaged with your treatment plan

Plot where your patient ‘scores’ on the two axes

Plot your scores on the graphs provided and try to identify which patient group or ‘profile’ best fits the description of your patient

Agree

Burden of disease

Engaged with treatment

Agree a bit

Disagree a bit

Disagree

Plot where your patient ‘scores’ on the two axes

Plot your scores on the graphs provided and try to identify which patient group or ‘profile’ best fits the description of your patient

Agree

Burden of disease

Engaged with treatment

Agree a bit

Disagree a bit

Disagree

Self-manager

Why me Help me!

Actively engaged

Plot where your patient ‘scores’ on the two axes

For example, this patient is highly engaged with treatment, with occasional disease burden…

Agree

Burden of disease

Engaged with treatment

Agree a bit

Disagree a bit

Disagree

Self-manager

Plot where your patient ‘scores’ on the two axes

…it is likely that they are in the ‘self-manager’ category

Agree

Burden of disease

Engaged with treatment

Agree a bit

Disagree a bit

Disagree

Why me Help me!

Actively engaged

Plot where your patient ‘scores’ on the two axes

Plot your scores on the graphs provided and try to identify which patient group or ‘profile’ best fits the description of your patient

Agree

Burden of disease

Engaged with treatment

Agree a bit

Disagree a bit

Disagree

Self-manager

Why me Help me!

Actively engaged

Timing

• 40 mins to work through the case study and profile the patient as a group

• 15 mins discussion within your group• How you might adapt your consultation for this patient

• What information would you provide this patient

• 15 mins feedback/discussion with the wider group

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We identified different means to increase the segments’ satisfaction with prescription topical efficacy

Self-managers require…

• Focused treatments with short-term results

• Treatments that live up to their fear of side

effects (especially their reluctance towards

steroids)

• Products specialised in reducing visibility

Actively engaged require…

• Further improved products (regarding

efficacy and burden of treatment)

• A sustainable treatment

•Informed about new treatments

LOW DISEASE IMPACT HIGH DISEASE IMPACT

Why me? require…

• Effective and low burden medical

treatments

• A better and less confusing understanding

of psoriasis

• An environment that understands and

cares about their psoriasis

Help me require…

• Conviction that products have real

medical value

• A systemised treatment regimen

• Clearer instructions and increased care

• New hope, quick wins