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1 Patient profiling

2 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

3 Large, multinational study to help understand different patient types who might benefit from individualised interventions Countries participating in the study Identifying patients who are in need of additional support

4 Research insights: study design Stage 1 Qualitative 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 Stage 2 Quantitative Qualitative stage guided development of the quantitative questionnaire and sample Online methodology, 40 minutes 3822 patients with psoriasis* Markets: Patient criteria 18 years old or over Suffer from psoriasis and/or psoriatic arthritis UK FR DE ES IT US CA Tot *Includes the 1884 patients currently using prescription treatments for psoriasis that are reported in Bewley et al. J Eur Acad Dermatol Venereol 2014;28:

5 Robust methodology for generating a patient profile Phase 1: Burden of psoriasis studies Capture of patient data via interviews, course-of-day exercises, photo diaries and field notes Link between medical and psychological well-being Channels of influence, variations in perception of treatment Large amounts of raw ethnographic data Data processing, analysis and synthesis Understanding of the relationship between burden of disease and burden of treatment: parameters for patient classification Quantitative validation and ranking of data Quantification of core emotional drivers/patient segments, understanding of patient relationship with treatment and HCPs

6 Robust methodology for generating a patient profile Phase 2: Patient profiles Integration of data from burden of psoriasis studies, data from other patient panels and groups, and social media listening Data clustered based on patients needs and preferences Identification of patterns for profiles that represent poles within population of psoriasis patients Consolidation of the profiles: establishing clear delineations with respect to burden of disease and treatment Validation of the profiles with GPs and dermatologists

7 Profiles are based on key intrinsic, behavioural and attitudinal characteristics Intrinsic characteristics Patient history with psoriasis Burden of disease/treatment scores Differentiating behaviours Treatment choice Frequency of HCP visits QoL impact Differentiating attitudes Satisfaction with current medication Receptivity to new treatments Trust in HCPs

8 Research insights: understanding patients Engagement with treatment High Self-manager 40% Why me? 28% Actively engaged 16% Help me 16% Low Low High Burden of disease

9 NEGATIVE EXPERIENCE POSITIVE EXPERIENCE The four segments all have distinct problems with prescription topicals Self-manager Irregular treatment (mix and match/fire fighting) caused by a fear of side effects and an unmet need for more specific treatments I know cortisone creams help but I use them only sometimes. 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. Among PTs, there are not enough choices LOW DISEASE IMPACT PTs are still a compromise HIGH DISEASE IMPACT Why me? Dropped out after a frustrating experience of trial-and-error with PTs There are no creams that help, so why bother then? Help me Deep disappointment with efficacy of PTs, therefore not considering them as proper medical treatment Creams are creams, a waste of time I want real medicine. Given up on PTs and the HCS Overall low involvement with medicine HCS, healthcare system; PT, psoriasis treatments

10 Four patient profiles developed 40% 16% Self-manager Actively engaged 28% 16% Why me? Help me

11 NEGATIVE EXPERIENCE POSITIVE EXPERIENCE 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 PT products (regarding efficacy and burden of treatment) A treatment more sustainable than systemics A treatment that can usefully complement systemics from the outside (skin) 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 from the HCS New hope

12 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

13 Profile: Why me? 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

14 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

15 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

16 Interactive session PROFILING YOUR PATIENTS Refer to handout

17 Answer key questions about your patient to assist in profiling Burden of disease Engagement with treatment Why me? Self-manager Help me Actively engaged

18 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

19 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

20 Plot where your patient scores on the two axes Engaged with treatment Agree Agree a bit Disagree a bit Disagree Burden of disease Plot your scores on the graphs provided and try to identify which patient group or profile best fits the description of your patient

21 Plot where your patient scores on the two axes Engaged with treatment Agree Self-manager Actively engaged Agree a bit Disagree a bit Why me Help me! Disagree Burden of disease Plot your scores on the graphs provided and try to identify which patient group or profile best fits the description of your patient

22 Plot where your patient scores on the two axes Engaged with treatment Agree Agree a bit Disagree a bit Disagree Burden of disease For example, this patient is highly engaged with treatment, with occasional disease burden

23 Plot where your patient scores on the two axes Engaged with treatment Agree Self-manager Actively engaged Agree a bit Disagree a bit Why me Help me! Disagree Burden of disease it is likely that they are in the self-manager category

24 Plot where your patient scores on the two axes Engaged with treatment Agree Self-manager Actively engaged Agree a bit Disagree a bit Why me Help me! Disagree Burden of disease Plot your scores on the graphs provided and try to identify which patient group or profile best fits the description of your patient

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26 Questions about burden of disease Scoring Never = 0 Occasionally = 1 Often = 2 A lot = 3 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 stops you from doing the things you like to do Your psoriasis affects your confidence Your psoriasis stops you from socialising, going out or playing sports Your psoriasis flares Your psoriasis is itchy Total out of 24

27 Questions about engagement with treatment Patient s engagement with treatment Range 1. My treatment makes a difference to my skin I like my treatments Scoring 0 = disagree 1 = disagree a bit 2 = agree a bit 3 = agree 3. I follow the treatment regime recommended to me by my HCP My lifestyle doesn t interfere with my regime Treatment really works for my psoriasis I understand how using my treatment helps me I like going to see my doctor/nurse/hcp I have time to use my treatments Total out of 24

28 Assign patient profiles using disease impact and engagement scores Disease burden 0 12 Engagement with treatment 0 12 Why me? Selfmanager Help me Actively engaged

29 Plot where you think your patient scores to the question Engagement with treatment 24 Self-manager 40% Actively engaged 16% Why me 28% Help me! 16% Burden of disease Plot your scores on the graphs provided and try to identify which patient group or profile best fits the description of your patient