Psoriasis Education Tool for Patient-physician Decision-making About Biologics

A Pilot Study

Marissa Nahirney, BHSc; Matthew Hum, MD, CCFP; Pamela Mathura, MBA; Marlene Dytoc, MD, PhD, FRCPC


Skin Therapy Letter. 2021;26(6) 

In This Article


Our investigation used a pragmatic quality improvement (QI) research approach as it provides a systematic inquiry that generates actionable knowledge aimed at improving the delivery of patient care.[2] This study employed the Model of Improvement, which provided our study with a roadmap for knowledge translation to developed actions, where through an experimentation (Plan-Do Study-Act, PDSA) cycle and practical experience leads to continuous improvement.[3] A PDSA cycle is a systematic approach to planning an intervention, assessing its impact, and proceeding with another cycle of implementation after improvements have been made.[3,4]

With the goal of developing a clinical teaching tool, we consolidated information on biologics available to patients in Canada as of December 2019 (Table 1).

Once consent was obtained from dermatologists and senior dermatology residents, they completed a questionnaire to determine general preferences and reasons for prescribing biologics. Clinicians then used the educational tool to discuss treatment options with their psoriatic patients. After 3 months of use, physicians completed a post-implementation questionnaire. The patients were also provided with an anonymous questionnaire at the end of the visit.

Descriptive statistics were used to understand the characteristics affecting dermatologists' biologic prescribing preference.[5] We used bar graphs to visually determine the factors that dermatologists prioritize when prescribing biologics, as well as the post-implementation data collected from patients about the utility of the visual aid for their involvement in decision-making. Weighted means were calculated for physician biologic preferences at baseline and after 3 months of visual aid use, assigning a score of 5 to each physician's most-preferred treatment, and 1 for the least-preferred. This project was approved by the Research Ethics Board at the University of Alberta (Pro00091432).