A recent study published in JAMA Dermatology sheds light on the experiences of Latine individuals living with moderate to severe psoriasis, a condition that disproportionately affects this group in the United States. The research underscores significant health disparities, including severe disease outcomes, limited access to care, and a reduced quality of life. The findings aim to improve intervention strategies, foster greater engagement in treatment, and address gaps in research participation.
Psoriasis, a chronic inflammatory skin disorder, is estimated to affect around 1.9% of the Hispanic population in the U.S., though experts suggest this figure may be underreported. According to Dr. Mona Shahriari, an assistant clinical professor of dermatology at Yale University and associate director of clinical trials at Central Connecticut Dermatology, this underreporting may be attributed to factors such as underdiagnosis, selection bias, and lower healthcare utilization in the Hispanic population compared to their Caucasian counterparts.
The study, which involved 30 participants, focused on understanding the perceptions, challenges, and preferences of Latine adults with psoriasis. These individuals were identified through medical records, with recruitment conducted via mail, telephone, or in-person visits between July and August 2022. The interviews, led by a bilingual researcher, were semi-structured and conducted in either English or Spanish, lasting approximately 45 minutes each. Topics included disease perception, treatment experiences, and attitudes toward psoriasis research.
Through the qualitative analysis, the researchers identified six primary themes that capture the lived experiences of Latine individuals with psoriasis:
Illness Perception of Psoriasis
Many participants were unfamiliar with psoriasis, often mistaking it for conditions such as eczema or fungal infections. Common misconceptions included the belief that psoriasis was contagious, with some linking the condition to stress, diet, or emotional factors like “nervios” (nervousness).
Reliance on Sociofamilial Connections for Medical Decision-Making
Family and friends played a crucial role in medical decisions, with many participants turning to their sociofamilial networks for advice. However, this support was not always medically informed, leading to potential risks in treatment choices.
Impact on Work Life
The condition’s physical symptoms—such as lesions triggered by heat, dust, and tight uniforms—had a notable impact on participants’ professional lives. Stigma associated with visible lesions affected job opportunities, though some reported receiving support from coworkers who offered accommodations.
Barriers to Accessing Dermatologic Care
Language and cultural barriers were significant obstacles to accessing dermatologic care. Many participants expressed confusion regarding insurance, and there was a lack of trust in interpreters, which further complicated the care process. Additionally, work schedules often clashed with the availability of treatments like phototherapy.
Receptiveness to Prescription and Nonprescription Treatments
Participants showed openness to both prescription and nonprescription treatments, including biologic medications and remedies from Latin American cultures. However, a few individuals described adverse reactions to medications purchased outside the U.S., pointing to the potential risks associated with non-regulated treatments.
Positive Perception and Interest Toward Research
There was a positive outlook toward biologic treatments, with some participants noting the effectiveness of injections. Many also expressed an interest in participating in research, seeing it as an opportunity to advance psoriasis treatment and help others in the Latine community.
The study’s authors acknowledged several limitations, particularly the fact that it was conducted within a single institution, a safety-net system where biologic medications are often accessible through prior authorization or low-income assistance programs. As a result, the findings may not fully reflect the experiences of Latine individuals in other healthcare settings or income brackets.
Despite these limitations, the researchers emphasized that the study provides valuable insights into the attitudes of Latine individuals toward psoriasis treatment and their willingness to participate in research. The study calls for further exploration of educational interventions and the acceptability of biologics among Latine populations.
“Clinicians and researchers should recognize that practices and attitudes toward research and treatments can vary significantly across racial and ethnic minority groups,” the researchers concluded. “Future studies should explore how to better educate and involve Latine communities in psoriasis treatment and research initiatives.”
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