A smartphone application supporting patients with psoriasis improves adherence to topical treatment: a randomized controlled trial

Background Adherence to topical psoriasis treatments is low, which leads to unsatisfactory treatment results. Smartphone applications (apps) for patient support exist but their potential to improve adherence has not been systematically evaluated. Objectives Methods To evaluate whether a study-specific app improves adherence and reduces psoriasis symptoms compared with standard treatment. We conducted a randomized controlled trial (RCT, clinicaltrials.gov registration: NCT02858713). Patients received once-daily medication [calcipotriol/betamethasone dipropionate (Cal/BD) cutaneous foam] and were randomized to no app (n = 66) or app intervention (n = 68) groups. In total, 122 patients (91%) completed the 22-week follow-up. The primary outcome was adherence, which was defined as medication applied >= 80% of days during the treatment period and assessed by a chip integrated into the medication dispenser. Secondary outcomes were psoriasis severity measured by the Lattice System Physician's Global Assessment (LS-PGA) and quality of life, measured using the Dermatology Life Quality Index (DLQI) at all visits. Results Conclusions Appendix Intention-to-treat analyses using regression was performed. More patients in the intervention group were adherent to Cal/BD cutaneous foam than those in the nonintervention group at week 4 (65% vs. 38%, P = 0 center dot 004). The intervention group showed a greater LS-PGA reduction than the nonintervention group at week 4 (mean 1 center dot 86 vs. 1 center dot 46, P = 0 center dot 047). A similar effect was seen at weeks 8 and 26, although it did not reach statistical significance. This RCT demonstrates that the app improved short-term adherence to Cal/BD cutaneous foam treatment and psoriasis severity.