Tucker Rod, Stewart Derek
School of Pharmacy & Life Sciences, Robert Gordon University, Aberdeen, UK.
Int J Pharm Pract. 2017 Apr;25(2):140-146. doi: 10.1111/ijpp.12298. Epub 2016 Aug 4.
The majority of patients with psoriasis have mild to moderate disease which can be managed in primary care with topical therapies. The supportive role of pharmacists for patients with long-term dermatological conditions is largely unknown.
To assess the impact of an educational intervention delivered by community pharmacists to improve self-management for people with psoriasis.
The study involved a pre- and post-intervention design. Seven community pharmacies were selected based on their location (urban, rural etc.) and the pharmacists recruited via local comprehensive research networks. Patients with mild to moderate psoriasis were recruited either opportunistically or via a letter of invite by pharmacists who undertook a face-to-face consultation with one follow-up visit after 6 weeks. The primary outcome was the change in person-centred dermatology self-care index (PEDESI) score and secondary outcomes were the self-assessed psoriasis and severity index (SAPASI), measuring disease severity and the dermatology quality of life index (DLQI).
A total of 47 patients were recruited. At 6 weeks, 42/47 (89.3%) patients completed the follow-up consultation. There was a significant increase in mean PEDESI scores (25.15 versus 17.78, P < 0.001) at 6 weeks compared to baseline. Similarly, SAPASI (11.60 versus 7.74, P < 0.001) and DLQI (7.21 versus 4.14, P < 0.001) scores improved significantly.
Pharmacist-assisted support for patients with psoriasis improved knowledge, reduced disease severity and the impact on quality of life. These results suggest that community pharmacists might have an important role to play in facilitating self-management for patients with psoriasis.
大多数银屑病患者病情为轻至中度,可在初级保健机构采用局部治疗方法进行管理。药剂师对患有长期皮肤病的患者的支持作用在很大程度上尚不明确。
评估社区药剂师提供的教育干预措施对改善银屑病患者自我管理的影响。
该研究采用干预前和干预后的设计。根据地理位置(城市、农村等)选择了7家社区药房,并通过当地综合研究网络招募药剂师。轻至中度银屑病患者通过机会性招募或由药剂师发出邀请信招募,药剂师进行面对面咨询,并在6周后进行一次随访。主要结局是以人为中心的皮肤科自我护理指数(PEDESI)评分的变化,次要结局是自我评估的银屑病及严重程度指数(SAPASI),用于衡量疾病严重程度,以及皮肤科生活质量指数(DLQI)。
共招募了47名患者。在6周时,47名患者中有42名(89.3%)完成了随访咨询。与基线相比,6周时平均PEDESI评分显著增加(25.15对17.78,P<0.001)。同样,SAPASI(11.60对7.74,P<0.001)和DLQI(7.21对4.14,P<0.001)评分也显著改善。
药剂师对银屑病患者的辅助支持提高了患者的知识水平,降低了疾病严重程度及其对生活质量的影响。这些结果表明,社区药剂师在促进银屑病患者的自我管理方面可能发挥重要作用。