Psoriasis-Specific Digital Therapeutic Tool Offers Psychological Benefits

Donal Fortune, PhD

New data on a psoriasis-specific digital therapeutic solution (Allay) suggested that the tool could be used to improve resilience, mood, and the overall perspective of the condition in affected patients.

Psoriasis is inextricably linked to psychological distress including anxiety and depression, and these associations can lead to interference with treatment and reductions in treatment efficacy.

In recent years, researchers and advocates have vocalized increasing psychological support for patients with psoriasis.

A recent study indicated that patients with psoriasis who were provided with education and support through a disease monitoring smartphone application experienced significant reductions in anxiety and depression over 60 weeks.

Investigators led by Donal Fortune, PhD, University of Limerick, assessed the feasibility and acceptability of the digital therapeutic solution Allay in patients with psoriasis while also providing data on psychological changes pre-post.

The Methods

All patients of the phase 1 proof of concept investigation were recruited from the dermatology center at University Hospital Limerick (n=55) and at Forest Hills Dermatology in New York (n=11).

Patients with guttate, erythrodermic or generalized pustular psoriasis were excluded from the study.

Research staff from both hospitals identified participants who routinely attended dermatology services for their psoriasis, and those who expressed interest were enrolled in the 12-week program.

Investigators utilized the Dermatology Life Quality Index (DLQI), the 6-item Brief Resilience Scale, Brief Illness Perception Questionnaire (B-IPQ), the Psoriasis Symptom Inventory (PSI), and Patient Health Questionnaire (PHQ) to measure everything from patient’s mental health to the severity of their psoriasis.

Participants were provided with Allay on their smartphone or other devices before continuing under their typical care of their dermatology services.

Allay featured awareness activities to promote the interacting roles of thoughts, emotion, and behaviors regarding psoriasis, as well as gratitude and forgiveness activities intended to promote compassion and conceptualization of a healthy life.

Participants experiences were collected by telephone interviews at weeks 4, 8, and 12.

The Findings

Of the 66 participants featured in the study, 59 continued using Allay after the familiarization phase and a total of 34 participants completed the program.

Investigators observed that participants showed statistically significant improvements between induction and the end of the 12 week program in regards to QoL, resilience, the perceptions of the overall effects psoriasis, and the emotional implications of the disease.

Notably, women participants used Allay more frequently than men, ranging from 3.1 times more frequently in weeks 1–4, 1.9 times more frequently in weeks 4–8, and 4.2 times more frequently in weeks 8–12.

Furthermore, throughout the 12 weeks of study Awareness (85.3%), Inquiry-Based Stress Reduction (73.5%) and Gratitude activities (58.8%) were deemed the most helpful by participants during telephone check-ins.

A significant change regarding symptoms of depression were seen over the course of using Allay, but not anxiety. Additionally, no interaction between changes in psoriasis symptoms and changes in depression, resilience or beliefs in emotional impact were observed.

“Given that this is a phase one proof of concept study, and our rates of attrition further research is necessary to examine comparative effectiveness and stability of these findings,” the team wrote.

The study, "