Study Highlights Views, Experiences of Latine Patients with Psoriasis

Patients with psoriasis identifying as Latine have several common disease-related beliefs and experiences with others that have psoriasis, new findings suggest, though several unique beliefs have been identified among such patients.1

Some of these beliefs include fears of loss of work due to prejudice resulting from psoriasis appearance and views that the condition was brought on by such causes as nervousness or food and nutrition. The findings on Latine patient views resulted from a new study authored in part by Nathaly Gonzalez, MS, BS, from the Medical College of Wisconsin School of Medicine in Milwaukee.

“Studies have also found that Latine patients often avoid discussing home remedies with their clinicians,” Gonzales and colleagues wrote. “Given these inequities and cultural context, we aimed to explore US-residing Latine patients’ perceptions of and experiences with psoriasis and their attitudes toward treatment and research.”1,2

Background and Design

The investigators conducted a qualitative study, implementing an inductive thematic analysis approach for the purposes of assessing adult Latine patients’ experiences with psoriasis. They recruited such individuals from an urban safety-net hospital in San Francisco, specifically at a dermatology clinic in which subjects were selected using convenience sampling.

All subjects of this analysis were insured through either Medicaid or Healthy San Francisco, a program designed for lower-income patients shown not to be eligible for other insurance. The team’s recruitment was done in patients' preferred language through mail, phone, or in-person clinic interactions, and they ensured that all study materials were translated by a bilingual researcher who had been trained to ensure accessibility.

Criteria for study eligibility included adult participants with Hispanic or Latino ethnicity noted in their medical records, those who spoke English or Spanish, and those who had provided with a moderate to severe psoriasis diagnosis by a dermatologist and allowed to receive systemic therapies at any stage of their skin condition.

The research team carried out their participant interviews utilizing a semi-structured format informed by clinical expertise, a literature review, and informal discussions with medical researchers identifying as Latine. Through Zoom or in-person, the team provided questions formulated to explore respondents’ views and experiences with psoriasis care, as well as their own understanding of the skin disease, and their perspectives on research.

The researchers provided a bilingual team member who was certified in qualitative interview methods to perform these interviews, the length of which was an average of 45 minutes. These meetings between investigators and participants took place in the timeframe between July 7 - August 3, 2022.

Compensation was also provided to study subjects. The investigative team continued their recruitment of participants up until data saturation was achieved, suggesting a lack of new themes emerging. The team also had participants self-describe demographic data, asking participants about their gender, age, preferred language, and status of employment.

While participants were not directly asked about their country of origin or immigration status due to the sensitive nature of these topics, such details were recorded if they arose organically during the interviews.

Notable Findings

The research team’s work ended up involving 30 participants, with the average age of these subjects being 50 years with a standard deviation of 11 years. Among the 15 individuals who gave the team information on their country of origin or ancestry, it was noted that 23% identified as being from Mexico, 7% from El Salvador, 13% from Guatemala, and 3% from Nicaragua, Honduras, and Peru.

The investigators found that a majority of their study’s respondents, or 67% specifically, had been reported to be male. They added that 73% expressed their preference for Spanish as their primary language.

The analysis demonstrated that there had been 6 interconnected themes that characterized the experiences of participants: the importance of sociofamilial networks in the guiding of medical decisions; perception of psoriasis as an illness; the effect of the condition on their work; challenges observed in obtaining high-quality dermatologic treatment and management; openness to both prescription and over-the-counter medications; and a generally positive attitude and interest in taking part in related research.

These data indicate that additional research may be necessary for the purposes of assessing educational interventions. The team added that this may allow for a better understand of the desires and views of Latine patients, particularly related to the use of biologic medications and their taking part in biomedical research initiatives.

“New insights gained include participants’ positive attitudes toward biologic medications, use of nonprescribed treatments and medications from abroad, and willingness to participate in research if language and education barriers are facilitated,” they wrote. “Dermatologists caring for Latine patients may consider inquiring about use of nonprescribed treatments and offering biologic medications when clinically appropriate.”1

References

1. Gonzalez N, Wilkerson K, Castillo Valladares H, Sanchez-Anguiano ME, Chang AY, Amerson EH. Latine Patients’ Beliefs, Attitudes, and Experience With Psoriasis. JAMA Dermatol. Published online January 08, 2025. doi:10.1001/jamadermatol.2024.5391.
2. Shelley BM, Sussman AL, Williams RL, Segal AR, Crabtree BF; Rios Net Clinicians. ‘They don’t ask me so I don’t tell them’: patient-clinician communication about traditional, complementary, and alternative medicine. Ann Fam Med. 2009; 7(2):139-147.