Shared Decision-making in Moderate to Severe Psoriasis

Patients benefit most from shared decision-making approaches that balance clinical expertise with individual preferences and circumstances. Effective shared decision-making avoids both extremes of presenting overwhelming treatment options without guidance or dictating single treatment choices without patient input. Health care providers should evaluate each patient’s disease severity, comorbidities, and lifestyle factors to identify appropriate treatment candidates before engaging in preference discussions.

Patients achieve better treatment outcomes when providers present a curated selection of suitable options rather than an exhaustive list of possibilities. The most effective approach involves identifying 2 or 3 treatments that can achieve clear or almost clear skin for the individual patient, then discussing administration preferences such as oral vs injectable options. Patients appreciate understanding treatment frequency, dosing schedules, and practical aspects of medication administration that affect their daily routines.

Patient adherence improves significantly when individuals participate actively in treatment selection and express their preferences regarding administration methods. Whether patients prefer once-daily oral medication or periodic injections every few weeks, involving them in the decision-making process leads to better long-term adherence and treatment success. Patients who feel heard and respected in their treatment preferences demonstrate greater commitment to their chosen therapy and achieve superior clinical outcomes through sustained adherence.