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患者与皮肤科医生在银屑病严重程度、症状和满意度方面的一致性:一项真实世界的多国家调查结果。

Patient-dermatologist agreement in psoriasis severity, symptoms and satisfaction: results from a real-world multinational survey.

机构信息

Dermatology Centre, Salford Royal Hospital, NIHR Manchester Biomedical Research Centre, University of Manchester, Manchester, UK.

Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.

出版信息

J Eur Acad Dermatol Venereol. 2018 Sep;32(9):1523-1529. doi: 10.1111/jdv.14937. Epub 2018 Jul 13.

Abstract

BACKGROUND

Psoriasis is a chronic immune-mediated inflammatory disease, which often requires lifelong treatment. A strong partnership between the patient and healthcare practitioners should help to achieve effective treatment outcomes.

OBJECTIVE

To assess concordance of views between patients with psoriasis and their treating dermatologists relative to psoriasis severity, presence of symptoms and satisfaction with disease control achieved.

METHODS

We used data from the Growth from Knowledge (GfK) Disease Atlas real-world evidence program, a syndicated, retrospective, cross-sectional survey among dermatologists and their systemic therapy eligible patients with psoriasis, conducted across nine countries. Concordance was measured through patients and their dermatologist's identical answers to the same survey questions. Concordance was evaluated using percentage agreement between dermatologists and their patients, and Cohen's kappa (κ) statistic. The level of concordance was defined as 'none' (κ ≤ 0), 'none to slight' (0.01-0.20), 'fair' (0.21-0.40), 'moderate' (0.41-0.60), 'substantial' (0.61-0.80) and 'almost perfect' (>0.8). The analysis was conducted for the overall population and for each participating country.

RESULTS

Overall, 524 dermatologists and 3821 patients with psoriasis were included in the survey. Concordance of patient and dermatologist perceptions of psoriasis severity was fair both at diagnosis, and at the time of the survey (61% agreement, κ = 0.326 and 55% agreement, κ = 0.370, respectively). Higher levels of concordance were reported when patients assessed their psoriasis as moderate-to-severe (using Investigator's Global Assessment/Physician's Global Assessment [IGA/PGA] 5-point scale of 3 or 4). Concordance regarding symptoms ranged from fair to moderate (κ = 0.241-0.575). Satisfaction with psoriasis control was fair (39% agreement, κ = 0.213). Results showed different patterns of concordance across the participating countries although a low concordance was observed on the satisfaction with psoriasis control in all of them.

CONCLUSION

Results from this multinational real-world survey indicate different perceptions between patients with psoriasis and their dermatologist with respect to psoriasis severity, symptoms and disease control.

摘要

背景

银屑病是一种慢性免疫介导的炎症性疾病,通常需要终身治疗。患者与医疗保健从业者之间建立强有力的合作关系有助于实现有效的治疗效果。

目的

评估银屑病患者与其治疗皮肤科医生在银屑病严重程度、症状存在和对疾病控制的满意度方面的观点一致性。

方法

我们使用了来自 GfK 疾病图谱真实世界证据计划的数据,这是一项在九个国家进行的针对皮肤科医生及其接受系统性治疗的银屑病合格患者的联合、回顾性、横断面调查。通过患者和皮肤科医生对相同调查问题的相同回答来衡量一致性。通过皮肤科医生和患者之间的百分比一致性和 Cohen's kappa(κ)统计来评估一致性。一致性水平定义为“无”(κ≤0)、“无到轻微”(0.01-0.20)、“公平”(0.21-0.40)、“适度”(0.41-0.60)、“大量”(0.61-0.80)和“几乎完美”(>0.8)。分析针对总体人群和每个参与国家进行。

结果

总体而言,共有 524 名皮肤科医生和 3821 名银屑病患者参与了这项调查。在诊断时和调查时,患者和皮肤科医生对银屑病严重程度的看法具有公平的一致性(61%的一致性,κ=0.326;55%的一致性,κ=0.370)。当患者使用研究者全球评估/医生全球评估(IGA/PGA)5 分制评估为中度至重度(评分为 3 或 4)时,报告的一致性水平更高。症状的一致性程度从公平到中度不等(κ=0.241-0.575)。对银屑病控制的满意度为公平(39%的一致性,κ=0.213)。尽管在所有国家对银屑病控制的满意度都表现出低一致性,但结果显示出不同的一致性模式。

结论

这项多国家真实世界调查的结果表明,银屑病患者与其皮肤科医生在银屑病严重程度、症状和疾病控制方面存在不同的看法。

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