Department of Dermatology, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy.
Br J Dermatol. 2013 Jan;168(1):201-5. doi: 10.1111/j.1365-2133.2012.11205.x. Epub 2012 Dec 13.
Psoriasis is a chronic disease which requires long-term therapy. Therefore, adherence to therapy and patient motivation are key points in controlling the disease. Mobile-phone-based interventions, and in particular text messages (TM), have already been used effectively to motivate patients and improve treatment adherence in many different chronic diseases such as diabetes, cardiovascular disease and asthma.
To evaluate the use of TM in improving treatment adherence and several patient outcomes such as quality of life, disease severity, patient-perceived disease severity and the patient-physician relationship.
Daily TM, providing reminders and educational tools, were sent for 12 weeks to a group of 20 patients with psoriasis. At the beginning and end of the study the following assessments were performed: Psoriasis Area Severity Index (PASI), Self-Administered Psoriasis Area Severity Index (SAPASI), body surface area (BSA), Physician Global Assessment (PGA), Dermatology Life Quality Index (DLQI), evaluation of patient-physician relationship and adherence to therapy. A matched control group of 20 patients with psoriasis was used for comparison of the same outcomes.
Both patient groups had similar scores for PASI, SAPASI, BSA, PGA and DLQI at baseline. However, after 12 weeks the intervention group reported a significantly better improvement of disease severity as well as quality of life, showing lower values of PASI, SAPASI, BSA, PGA and DLQI with respect to the control group (P<0·05). Moreover, adherence to therapy improved in a statistically significant way (P<0·001) whereas it remained stable in the control group. Similarly, TM interventions led to an optimization of patient-physician communication.
TM interventions seem to be a very promising tool for the long-term management of patients with psoriasis, leading to an increased compliance to therapy, positive changes in self-care behaviours and better patient-physician relationship allowing improved clinical outcomes and better control of the disease.
银屑病是一种需要长期治疗的慢性疾病。因此，坚持治疗和患者的积极性是控制疾病的关键。基于手机的干预措施，特别是短信（TM），已经被有效地用于激励患者并提高许多不同慢性疾病（如糖尿病、心血管疾病和哮喘）的治疗依从性。
评估 TM 在提高治疗依从性和改善生活质量、疾病严重程度、患者感知的疾病严重程度和医患关系等患者结局方面的应用。
对 20 例银屑病患者进行为期 12 周的每日 TM，提供提醒和教育工具。在研究开始和结束时进行以下评估：银屑病面积严重程度指数（PASI）、自我评估银屑病面积严重程度指数（SAPASI）、体表面积（BSA）、医生整体评估（PGA）、皮肤病生活质量指数（DLQI）、医患关系评估和治疗依从性。使用 20 例银屑病匹配的对照组进行比较。
两组患者在基线时 PASI、SAPASI、BSA、PGA 和 DLQI 评分相似。然而，12 周后，干预组报告疾病严重程度和生活质量有显著改善，与对照组相比，PASI、SAPASI、BSA、PGA 和 DLQI 值较低（P<0·05）。此外，治疗依从性有统计学意义的改善（P<0·001），而对照组则保持稳定。同样，TM 干预措施导致医患沟通得到优化。
TM 干预措施似乎是治疗银屑病患者的一种非常有前途的工具，可提高治疗依从性，积极改变自我护理行为，并改善医患关系，从而改善临床结局并更好地控制疾病。
