OBJECTIVES: Psoriasis is a chronic, immune-mediated inflammatory skin disease characterized by the development of red, scaly plaques. Various treatments such as topical therapies, phototherapy, systemic oral therapy, and biologics are used to manage psoriasis. However, adherence to treatments is not well established due to long-term complex treatment. This systematic literature review (SLR) was conducted to assess treatment adherence rates and reasons of non-adherence in psoriatic patients.

METHODS: EMBASE® was searched from database inception till December 2023 for the studies conducted in a real-world setting. The search strategy included different combinations of keywords like “psoriasis”, “treatment adherence”, and “medication adherence”. For each article, the following outcomes were extracted: method of adherence measurement, adherence rate, and reason for non-adherence.

RESULTS: This SLR identified 18 studies that were eligible for inclusion. Among these, adherence rates were reported in nine studies each for topical therapy, and oral therapy, seven studies for biologics therapy administered via the parenteral route, and two studies for phototherapy. Overall treatment adherence rates ranged from 31.5% to 62%. Adherence rates were higher for biologics (83.6% to 100%), when compared to oral agents (81% to 95.4%), phototherapy (60.7% to 93%) and topical therapy (44.3% to 72%). Reasons for lower adherence rates to topical medications were low efficacy (6% to 27%), poor cosmetic characteristics (11% to 29%), time consuming (10% to 78.4%), side effects (3% to 18%), unclear instructions (1% to 11%), fed up (21.1% to 42.9%), costs (5% to 18%) and forgetfulness (9.09% to 55.9%).

CONCLUSIONS: Treatment adherence rates were low, particularly with topical treatments when compared to other therapies. Improvement in cosmetic characteristics and other areas of disease management may higher adherence with the topical agents.