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Patient preference on psoriasis treatment in a Philippine tertiary hospital: A conjoint analysis

Authors: Nikki G. Gonzales, MD, Bryan Edgar K. Guevara, MD and Lalaine R. Visitacion, MD


Background: Psoriasis is a common and chronic papulosquamous skin disease leading to dissatisfaction and non-adherence to treatment among patients. Dermatologists should identify preferences of patients in choosing treatment options in order to optimize treatment satisfaction, adherence and outcome.

Objectives: To determine patients’ preferences for psoriasis treatments and analyze these preferences according to patients’ sociodemographic and socioeconomic profiles.

Methods: This was a cross-sectional study among adult patients with psoriasis seen at the Outpatient Department of a tertiary hospital, evaluating their preferences for psoriasis treatments based on outcome and process attributes using a self-administered questionnaire. A conjoint analysis determined the most preferred treatment combinations. The validity of correlation was assessed using Pearson’s R and Kendall’s tau.

Results: Among the 62 respondents, the most preferred outcome attribute for treatment was duration of benefit (RIS, 42.72) followed by probability of adverse effects (RIS, 31.29) and magnitude of benefits (RIS, 25.99). Among the process attributes, the frequency of treatment (RIS, 33.34) was regarded as the most preferred, followed by mode (RIS, 26.46), location (RIS, 20.89) and cost of treatment (RIS,19.31). A topical medication taken or applied thrice weekly with cost of less than Php 500, and consulation done at the clinic setting, was the preferred process treatment combination. There were no significant differences in RIS across different sociodemographic and socioeconomic groups.

Conclusion: The findings of this study can give dermatologists guidance on the choice of treatment characteristics for patients with psoriasis that is close to their preferences to ensure good compliance and better outcome



Gonzales,N, Guevara, BE & Visitacion, L. (2017). Patient preference on psoriasis treatment in a Philippine tertiary hospital: A conjoint analysis. Journal of the Philippine Dermatological Society, 26(1), 23-35.



Psoriasis, Conjoint analysis

1. Van de Kerkhof P, Nestlé F. Psoriasis. In: Bolognia, J, Jorizzo JL, Schaffer JV, editors. Dermatology 3rd ed. Elsevier Limited. 2012; 135.

2. Gudjonsson JE, Elder J. Psoriasis. In: Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, editors. Fitzpatrick’s Dermatology in General Medicine 8th edition. New York: McGraw-Hill. 2008; 197.

3. Parisi R, Symmons DP, Groffiths CE, ASchroft DM, IMPACT project team. Global Epidemiology of Psoriasis: A Systematic Review of Incidence and Prevalance. J Invest Dermatol. 2013; 133.

4. Psoriasis Philippines. 2015. Retrived from: about-us.

5. Philippine Dermatological Society Health Information Systems. Philippine Dermatological Society. c2011 Available by request from:

6. Southern Philippines Medical Center Department of Dermatology patient census 2013.

7. Bhosle M, Kulkarni A, Feldman S, Balkrishnan R. Quality of life in patients with psoriasis. Health and Quality of Life Outcomes 2006; 4.

8. Schaarschmidt ML, Schmieder A, Umar N, Terris D, Goebeler M, Goerdt S, et al. Patient preferences for psoriasis treatments: process characteristics can outweigh outcome attributes. Arch Dermatol. 2011; 147: 1285-1294. doi: 10.1001/ archdermatol.2011.309. pmid:22106115.

9. Yu AP, Tang J, Xie J, Wu EQ, Gupta SR, Bao Y, Mulani PM. Economic burden of psoriasis compared to the general population and stratified by disease severity. Current Medical Research and Opinion. 2009; 10:2429-308.

10. Mrowietz U, Kragballe K, Reich K, Spuls P, Griffiths C, Nast A, Yawalkar N. Definition of treatment goals for moderate to severe psoriasis: a European consensus. Archives of Dermatological Research. 2011; 303(1):1-10.

11. Vangeli E, Bakshi S, Baker A, Fisher A, Bucknor D, Mrowietz U et al. A systemic review of factors associated with non-adherence to treatment for immune-mediated inflammatory disease. Adv Ther. 2015; 32(11):983-1028.

12. Seston E, Aschroft DM, Griffiths CEM. Balancing the benefits and risks of drug treatment. Archives of Dermatology. 2007; 143(9):1175-1179.

13. Brennan PF, Strombon I. Improving health care by understanding patient preferences. J Am Med Inform Assoc. 1998; 5(3):257-262.

14. IBM SPSS Conjoint 21 (2001). Retrieved from SPSS_Conjoint_21.pdf.

15. Meghani SH, Chittams J, Hanlon AL, Curry J. Measuring preferences for analgesic treatment for cancer pain: How do African-Americans and Whites perform on choice-based conjoint (CBC) anaylsis experiments? BMC Medical Informatics and Decision Making. 2013; 13:118.

16. Bridges J, Hauber AB, Marshall D, Lluoyd A, Prosser LA, Reiger DA, et al. Conjoint analysis applications in health – a checklist: a report of the ISPOR Good Research Practices for Conjoint Analysis. Value in Health. 2011; 403-413.

17. Casper GR, Brennan PF. Improving the quality of patient care: the role of patient preferences in the clinical record. (Proc 17th Annu Symp Comput Appl Med Care) 1993:8-11.

18. Visitacion, E. Clients’ Preferences on Clinical Laboratories in the Philippines. 2013. .

19. Orme, B. Getting Started with Conjoint Analysis: Strategies for Product Design and Pricing Research, 2nd edition 2010.

20. Walpole R. Probability and Statistics for Engineers and Scientists, 9th edition 2012.

21. Armstrong AW, Robertson AD, Wu J, Schupp C, Lebwohl MG. Undertreatment, treatment trends, and treatment dissatisfaction among patients with psoriasis and psoriatic arthritis in the United States: findings from the National Psoriasis Foundation surveys, 2003-2011. JAMA Dermatol. 2013; 149:1180-1185.

22. Kimball AB, Yu AP, Signorovitch J, Xie J, Tsaneva M, Gupta SR, et al. The effects of adalimumab treatment and psoriasis severity on self-reported work productivity and activity impairment for patients with moderate to severe psoriasis. J Am Acad Dermatol. 2012; 66:e67-76.

23. Vanderpuye-Orgle J, Yang Z, Lu J, Shreshta, Sexton A, Seabury S, Lebwohl. Evaluating the economic burden of psoriasis in he United States. J Am Acad Dermatol. 2015; 72(6):961-7.

24. Harris DL, Carr AT. Prevalence of concern about physical appearance in the general population. Br J Plast Surg. 2001; 54: 223-226.

25. Grozdev I, Kast D, Cao L, Carlson D, Pujari P, Schmotzer B, et al. Physical and mental impact of psoriasis severity as measured by the compact Short Form-12 Health Survey (SF-12) quality of life tool. J Invest Dermatol. 2012; 132: 1111-1116. doi: 10.1038/jid.2011.427.



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Patient preference on psoriasis treatment in a Philippine tertiary hospital: A conjoint analysis