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Gender and age significantly determine patient needs and treatment goals in psoriasis - a lesson for practice


Maul, J-T; Navarini, A A; Sommer, R; Anzengruber, F; Sorbe, C; Mrowietz, U; Drach, M; Blome, C; Boehncke, W-H; Thaci, D; Reich, K; von Kiedrowski, R; Körber, A; Yawalkar, N; Mainetti, C; Laffitte, E; Streit, M; Rustenbach, S; Conrad, C; Borradori, L; Gilliet, M; Cozzio, A; Itin, P; Häusermann, P; French, L E; Radtke, M A; Augustin, M (2019). Gender and age significantly determine patient needs and treatment goals in psoriasis - a lesson for practice. Journal of the European Academy of Dermatology and Venerology, 33(4):700-708.

Abstract

BACKGROUND: Though patient needs are key drivers of treatment decisions, they are rarely systematically investigated in routine care.
OBJECTIVE: This study aimed at analysing needs and expectations from the patient perspective in the German and Swiss psoriasis registries PsoBest and SDNTT with respect to treatment choice, age and gender.
METHODS: The German and Swiss psoriasis registries observe patients recruited at first-time use of systemic drugs. Within 10 years, clinical (Psoriasis Area Severity Index (PASI), Body Surface Area (BSA)) and patient-reported outcomes are documented, including the Dermatology Quality of Life Index (DLQI) and the Patient Benefit Index (PBI), characterizing patient needs for treatment. The analysis dataset includes n=4,894 patients from PsoBest and n=449 from SDNTT with mean follow-up time of 7.5 months.
RESULTS: 5,343 patients registered between 2008 and 2016 were included in the analyses (at baseline: 59.6% male, mean age 47.6 years±14.5, PASI 14.2±9.7, BSA 22.7±19.7, DLQI 11.3±7.2).The most important patient needs were to "get better skin quickly" and to "be healed of all skin defects". Subgroup analyses by age revealed significant differences in needs, especially higher needs regarding social impairments in patients younger than 65 years. Patients 65 years or older attributed more importance to sleep quality, less dependency on medical visits, fewer side effects and confidence in the therapy. Out of 25 items reflecting patient needs, 20 items were rated significantly more important by women than men, with the greatest differences regarding feeling of depression, sleep quality and everyday productivity. Divided by treatment, needs were rated differently, recommending individualized and targeted choice of therapy.
CONCLUSION: Age and gender stratify patient needs. Women showed higher expectations and rated specific needs in psoriasis treatment higher than men. Analyzing the patient needs on an individual level will facilitate shared decisions by patient and physician in finding the optimal personalized treatment. This article is protected by copyright. All rights reserved.

Abstract

BACKGROUND: Though patient needs are key drivers of treatment decisions, they are rarely systematically investigated in routine care.
OBJECTIVE: This study aimed at analysing needs and expectations from the patient perspective in the German and Swiss psoriasis registries PsoBest and SDNTT with respect to treatment choice, age and gender.
METHODS: The German and Swiss psoriasis registries observe patients recruited at first-time use of systemic drugs. Within 10 years, clinical (Psoriasis Area Severity Index (PASI), Body Surface Area (BSA)) and patient-reported outcomes are documented, including the Dermatology Quality of Life Index (DLQI) and the Patient Benefit Index (PBI), characterizing patient needs for treatment. The analysis dataset includes n=4,894 patients from PsoBest and n=449 from SDNTT with mean follow-up time of 7.5 months.
RESULTS: 5,343 patients registered between 2008 and 2016 were included in the analyses (at baseline: 59.6% male, mean age 47.6 years±14.5, PASI 14.2±9.7, BSA 22.7±19.7, DLQI 11.3±7.2).The most important patient needs were to "get better skin quickly" and to "be healed of all skin defects". Subgroup analyses by age revealed significant differences in needs, especially higher needs regarding social impairments in patients younger than 65 years. Patients 65 years or older attributed more importance to sleep quality, less dependency on medical visits, fewer side effects and confidence in the therapy. Out of 25 items reflecting patient needs, 20 items were rated significantly more important by women than men, with the greatest differences regarding feeling of depression, sleep quality and everyday productivity. Divided by treatment, needs were rated differently, recommending individualized and targeted choice of therapy.
CONCLUSION: Age and gender stratify patient needs. Women showed higher expectations and rated specific needs in psoriasis treatment higher than men. Analyzing the patient needs on an individual level will facilitate shared decisions by patient and physician in finding the optimal personalized treatment. This article is protected by copyright. All rights reserved.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Dermatology Clinic
Dewey Decimal Classification:610 Medicine & health
Uncontrolled Keywords:Infectious Diseases, Dermatology
Language:English
Date:1 April 2019
Deposited On:04 Jan 2019 11:27
Last Modified:30 Mar 2019 02:03
Publisher:Wiley-Blackwell Publishing, Inc.
ISSN:0926-9959
Additional Information:This is the peer reviewed version of the following article:J Eur Acad Dermatol Venereol. 2018 Nov 2. doi: 10.1111/jdv.15324., which has been published in final form at https://doi.org/10.1111/jdv.15324. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. (http://www.wileyauthors.com/self-archiving)
OA Status:Closed
Publisher DOI:https://doi.org/10.1111/jdv.15324
PubMed ID:30388318

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