Radtke M A, Reich K, Spehr C, Augustin Matthias
Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Germany,
Arch Dermatol Res. 2015 Jul;307(5):445-9. doi: 10.1007/s00403-014-1534-y. Epub 2014 Dec 31.
The treatment goal algorithm for psoriasis, first originated in 2007, has ever since been adopted into treatment guidelines. It remained unclear how many patients have experienced the use of treatment goals in routine care and how these are perceived. The aim of the pilot study was to get first insight in the use and impact of therapeutic goals in a large cohort of patients with psoriasis in routine care. This study is a multicenter, non-interventional, cross-sectional health care study in n = 213 dermatology centers across Germany. A standardized physician and patient questionnaire was used, including demographics, disease and treatment characteristics. To evaluate patient treatment perception and satisfaction, a questionnaire (PsoSat) addressing 8 specific items was designed. Consistency and validity of the questionnaire were controlled by factor analyses and reliability tests. In total n = 1,883 patients were included for analysis (54.2% male). Mean age was 52 years, mean disease duration 19 years. In total 45.5% (n = 856) stated an improvement of psoriatic symptoms in the last 4 weeks. In patients including treatment goals, the course of psoriasis in the last 4 weeks was rated significantly better and predicted significantly higher patient satisfaction. Patients reporting periodic outcomes measurement of psoriasis treatment, also had significantly better course of disease, higher satisfaction and a lower psoriasis severity. A majority of patients experienced the use of treatment goals in practice. The association of using treatment goals with clinical outcomes and treatment satisfaction was markedly positive. These findings indicate that the use of treatment goals and outcome measurements in fact improve psoriasis management.
银屑病治疗目标算法最早于2007年提出，此后被纳入治疗指南。目前尚不清楚有多少患者在常规治疗中采用了治疗目标以及他们对此的看法。这项初步研究的目的是初步了解在一大群接受常规治疗的银屑病患者中治疗目标的使用情况及其影响。本研究是一项在德国213个皮肤科中心进行的多中心、非干预性横断面医疗保健研究。使用了标准化的医生和患者问卷，包括人口统计学、疾病和治疗特征。为了评估患者对治疗的认知和满意度，设计了一份涉及8个具体项目的问卷（PsoSat）。通过因子分析和可靠性测试来控制问卷的一致性和有效性。总共纳入了1883例患者进行分析（男性占54.2%）。平均年龄为52岁，平均病程为19年。共有45.5%（n = 856）的患者表示在过去4周内银屑病症状有所改善。在纳入治疗目标的患者中，过去4周内银屑病的病程评分明显更好，患者满意度预测也更高。报告定期进行银屑病治疗效果评估的患者，疾病进程也明显更好，满意度更高，银屑病严重程度更低。大多数患者在实际治疗中经历了治疗目标的使用。使用治疗目标与临床结果和治疗满意度之间的关联明显为正。这些发现表明，使用治疗目标和效果评估实际上改善了银屑病的管理。
