Table 1 Sorting of the Harmonized Concepts Generated in GCM Exercises

Proximal Benefits

20. Clear outside symptoms, such as dryness and redness

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28. Be effective in treating joint disease

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38. Help control the itching

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40. Be effective in treating skin disease, including nails and scalp

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Relief from Symptom Manifestations

8. Free a patient from hiding problem skin

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19. Consider how much the symptoms affect a patient’s daily life

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22. Free a patient from feeling embarrassed

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Efficacy/General Efficacy

1. Resist building a tolerance

1. Result in the disappearance of rash

3. Not lose efficacy over time

2. Relieve the itching and associated discomfort

15. Be predictably effective

7. Absorb invisibly in my skin

26. Be strong enough to be effective, but mild enough not to cause other sicknesses or symptoms

9. Be effective with little to no side effects

41. Be effective

10. Control the itching

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11. Work fast and effective for thicker plaques

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12. Work longer than two hours

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17. Safe for long term daily use

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22. Control the itch longer

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35. Have little to no side effects

Accessibility

12. Be affordable under a patient’s insurance plan

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34. Be available under a patient’s insurance plan

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35. Not interfere with a patient’s occupational responsibilities

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Safety

4. Be safe for long term use (patient-generated)*

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5. Not damage a patient’s liver

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10. Not increase the risk of infection, cancer, or other disease

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14. Be safe to use for those with pre-existing conditions, such as renal failure, liver disease, or internal malignancy

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17. Be safe for long-term use (clinician-generated)*

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27. Not lower a patient’s immune system

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30. Be safe to use during pregnancy and lactation

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36. Have minimal, non-life-threatening side effects

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37. Consider potential side effects

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43. Have minimal interactions with other drugs and medications

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Convenience

2. Be able to adjust dosage to psoriasis severity

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6. Be simple and quick to administer

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7. Be able to take with or without a meal

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13. Not be very time-intensive or consuming

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16. Have an alternative to injections

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18. Be easy to include in a patient’s normal routine

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31. Not be messy

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32. Be convenient and easily managed by a patient

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33. Be easy to administer

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42. Be painless to use

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Administration/Mode of Administration

9. Not require multiple drugs

13. Require less frequent applications throughout the day

11. Be a medication implanted just below the skin

14. Is effective using once to twice weekly

21. Be an oral medication taken once a day

15. Be a once a day application that lasts

23. Be a topical ointment or cream

16. Be a once a month injection

24. Not require lab monitoring

25. Be easy to apply to all areas which need treatment

25. Be a once monthly injection

26. Come with gloves for application

29. Have infrequent dosing

31. Be a pill for long term use

39. Be an oral medication

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Application Characteristics

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7. Absorb invisibly in my skin

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24. Not affect the way my hair looks

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32. Not feel oily on the skin

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33. Be gentle enough for daily use on my scalp

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36. Not leave my hair oily

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37. Not damage clothing

Treatment Preferences

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18. Be a non-steroidal cream

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19. Have a hands free applicator

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20. Double as a safe mechanism for scratching

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21. Be easy to apply to the scalp

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23. Not be greasy

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27. Be an exfoliating solution that can get rid of the scale and flakes

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28. Be a liquid to give immediate relief

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29. Be gentle enough to use daily without damaging my hair

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30. Not involve placing oily drops in my ears

Prevention

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8. Clear the skin and keep it clear

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3. Prevent symptoms from occurring

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4. Prevent plaque buildup on my scalp

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5. Work from the inside to prevent itching

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6. Start with managing the triggers, like stress