Self-management experiences in adults with mild-moderate psoriasis: an exploratory study and implications for improved support

Background Psoriasis is a long-term condition affecting 2-3% of the population. The mainstay of treatment for mild-moderate disease is the regular application of topical medication by the individual. At present little is known about how people with psoriasis self-manage and how they may best be supported in this endeavour. Objectives To explore how adults with mild-moderate psoriasis manage their condition and to identify strategies that can support people to self-manage effectively. Methods A qualitative investigation was carried out using six focus groups to collect data from purposively sampled participants managed in the community (n = 22). Results Thematic data analysis generated three categories that offer new insights into how people currently manage their condition, their low expectations of health services and how self-management may be better supported. People with mild-moderate psoriasis do not always achieve what they perceive to be optimal self-management. They often do not use topical therapy systematically and frequently abandon it if rapid improvements are not seen. Factors which participants identified as likely to improve self-management included the provision of individualized education directed towards improving effective adherence techniques by medical and nonmedical personnel who have practical experience in topical application of psoriatic therapies. Conclusions People with mild-moderate psoriasis continue to find self-management problematic; however, they can identify strategies that could enable them to become more effective in self-managing. There is a need to incorporate these strategies in 'self-management plans' in order to support individuals to self-manage as effectively as possible to help improve their skin condition and quality of life.