OBJECTIVES:

To compare demographics and patient-reported outcomes (health-related quality of life [HRQoL] and work productivity and activity impairment [WPAI]) between diagnosed and treated vs. experiencing but undiagnosed individuals with moderate to severe psoriasis in the US.

METHODS:

Data from the 2021 US National Health and Wellness Survey, a nationally-representative, cross-sectional online survey, was analyzed. Respondents who self-reported experiencing moderate to severe psoriasis were stratified as having a physician diagnosis and use prescriptions (Rx) vs. not having a physician diagnosis. Demographics, HRQoL (SF-36v2), and WPAI were compared between groups using bivariate statistics.

RESULTS:

Among moderate/severe psoriasis individuals in the US (undiagnosed n= 775, diagnosed Rx n= 673), undiagnosed were younger with 41.4% falling into the 18-34 age bracket compared with 17.7% diagnosed Rx patients (p<0.05). The undiagnosed group had an overrepresentation of Hispanics (33.4%) and leaned towards male (65.2%). Whereas the diagnosed Rx group had an overrepresentation of White patients (74.9%). 78.8% of undiagnosed individuals reported some form of employment. Diagnosed Rx patients were more likely to be obese (36.3% vs 18.9%, p<0.05) and experience psoriatic arthritis (34.9% vs 17.9, p<0.05) than those were undiagnosed. However, undiagnosed individuals experienced COVID-19 at a higher rate than diagnosed Rx patients (40.8% vs 14.9%, p<0.05).

Undiagnosed individuals had worse mental component summary scores (34.92 vs 44.96, p<0.05) and physical component scores (40.71 vs 45.86, p<0.05); differences exceeded minimally important difference for these measures. There was also greater overall work impairment (78.19% vs 38.59%, p<0.05) compared with diagnosed Rx patients. Activity impairment was also significantly higher (66.62% vs 38.04%, p<0.05).

CONCLUSIONS:

Undiagnosed psoriasis individuals had higher work impairment and lower HRQoL (both mental and physical) compared with diagnosed and prescription treated psoriasis patients in the US. Improvements in diagnosis rates and treatment rates may help alleviate some of the burdens experienced by patients with psoriasis.