Vaidya Toral S, Anderson Kathryn L, Feldman Steven R
Wake Forest School of Medicine.
Dermatol Online J. 2015 Sep 17;21(9):13030/qt1dc037qk.
Though psoriasis is chronic and recurring, current options can help many patients achieve good disease control. New treatments could provide greater improvement in objective disease, but it is not clear that there is room for improving subjective outcomes, particularly for patients who are already "well-controlled."
To analyze treatment satisfaction of well-controlled patients with psoriasis in two patient populations of very different disease severity.
Patients with well-controlled psoriasis on topicals (mild psoriasis) only or on biologics (moderate-to-severe psoriasis) were queried by telephone about perceptions of disease control, improvement level, overall treatment satisfaction, and consideration for trying new treatments. Satisfaction scores and feedback were analyzed to assess treatment type and satisfaction level associations.
The majority of patients, regardless of disease severity, would consider trying new treatments for psoriasis, though patients with mild psoriasis were less satisfied with their disease control, level of improvement, and overall treatment. Patient feedback revealed widespread treatment dissatisfaction, non-adherence, and inconvenience.
The patient population was from one university setting.
16% of patients with psoriasis meet study definition for "well-controlled" disease. Less than 20% of these well- controlled patients with psoriasis are satisfied with their current level of control and clearance and would not consider trying new treatments, suggesting the majority of well-controlled patients, regardless of disease severity, still have unmet needs. Stronger patient-physician communication may contribute to patient-based, comprehensive care in concordance with a health system that is headed towards financial incentives for better patient satisfaction.
尽管银屑病是一种慢性复发性疾病,但目前的治疗方法可以帮助许多患者实现良好的疾病控制。新的治疗方法可能会在客观疾病改善方面有更大进展,但对于主观疗效是否还有提升空间尚不清楚,尤其是对于那些已经“病情得到良好控制”的患者。
分析在两种疾病严重程度差异很大的患者群体中,病情得到良好控制的银屑病患者的治疗满意度。
通过电话询问仅使用外用药物(轻度银屑病)或生物制剂(中度至重度银屑病)且病情得到良好控制的患者对疾病控制的看法、改善程度、总体治疗满意度以及尝试新治疗方法的意愿。对满意度得分和反馈进行分析,以评估治疗类型与满意度水平之间的关联。
大多数患者,无论疾病严重程度如何,都会考虑尝试治疗银屑病的新方法,不过轻度银屑病患者对疾病控制、改善程度和总体治疗的满意度较低。患者反馈显示普遍存在对治疗的不满、不依从和不便之处。
患者群体来自一所大学附属医院。
16%的银屑病患者符合“病情得到良好控制”的研究定义。在这些病情得到良好控制的银屑病患者中,不到20%的患者对目前的控制和清除水平感到满意,并且不会考虑尝试新的治疗方法,这表明大多数病情得到良好控制的患者,无论疾病严重程度如何,仍有未满足的需求。加强医患沟通可能有助于在以患者为基础的综合护理中,与朝着提高患者满意度提供经济激励的医疗系统保持一致。