Department of Dermatology, Mayo Clinic, Jacksonville, Florida, USA.
Department of Biomedical Engineering, Yale University, New Haven, Connecticut, USA.
Dermatol Ther. 2021 Mar;34(2):e14736. doi: 10.1111/dth.14736. Epub 2021 Jan 12.
Pyoderma gangrenosum (PG) lacks consensus regarding treatment, and no prior studies assess treatment satisfaction in PG. The objective of this study was to determine patient-reported satisfaction in the treatment of PG, and associations with satisfaction. Methodology was a multicenter cross-sectional survey for patients who received systemic medication(s) to treat PG. Thirty-five patients completed the survey (mean age: 54.0 years, 65.7% female, response rate: 81.4%). Mean (± SD) SATMED-Q score was 75.0 (±16.2, range: 67.6-85.3). Older patients (72.6 ± 23.6 for 18-39 years, 74.4 ± 16.1 for 40-59, 77.1 ± 11.6 for 60+), plus those with higher incomes (72.9 ± 20.3 for $0-49 000; 74.0 ± 17.6 for $50 000-99 000; 79.0 ± 14.6 for $100 000+) and education status (69.4 ± 14.3 for high school equivalent, 72.9 ± 15.9 for undergraduate, 91.7 ± 10.6 for graduate), were more satisfied with treatment. Ulcerative PG had higher SATMED-Q scores (79.0 ± 13.2) than other subtypes (66.2 ± 19.3). For local therapy, wound care, or pain control, 63.2%, 100%, and 75% were satisfied, respectively. The mean DLQI was 8.6 (±7.6, range: 0-29), and higher DLQI was associated with decreased satisfaction. Satisfaction with providers was positively correlated with global satisfaction (Pearson's r = 0.638). The presence of pain and/or depression influenced both SATMED-Q (72.8 ± 18.8 with pain, 78.3 ± 11.2 without; 68.2 ± 18.8 with depression, 80.1 ± 12.2 without) and DLQI scores (12.1 ± 8.1 with pain, 3.9 ± 3.4 without; 10.3 ± 7.1 with depression, 7.4 ± 8.0 without). To optimize the patient experience, non-modifiable associations should be individually considered, and potentially modifiable associations such as satisfaction with specific providers, pain, and depression, may be targeted for management.
坏疽性脓皮病(PG)的治疗方法尚无共识,既往研究均未评估 PG 患者的治疗满意度。本研究旨在确定接受系统药物治疗 PG 的患者的报告满意度及其与满意度的相关性。方法为对接受系统药物治疗 PG 的患者进行多中心横断面调查。35 例患者完成了调查(平均年龄:54.0 岁,65.7%为女性,应答率:81.4%)。平均(± SD)SATMED-Q 评分为 75.0(±16.2,范围:67.6-85.3)。年龄较大的患者(18-39 岁为 72.6±23.6,40-59 岁为 74.4±16.1,60 岁以上为 77.1±11.6)、收入较高的患者(0-49000 美元为 72.9±20.3,50000-99000 美元为 74.0±17.6,100000 美元以上为 79.0±14.6)和教育程度较高的患者(高中同等学历为 69.4±14.3,本科学历为 72.9±15.9,研究生学历为 91.7±10.6)对治疗的满意度更高。溃疡性 PG 的 SATMED-Q 评分为 79.0(±13.2)高于其他亚型(66.2(±19.3)。对于局部治疗、伤口护理或疼痛控制,分别有 63.2%、100%和 75%的患者满意。平均 DLQI 为 8.6(±7.6,范围:0-29),较高的 DLQI 与满意度降低相关。对提供者的满意度与总体满意度呈正相关(Pearson's r = 0.638)。疼痛和/或抑郁的存在影响 SATMED-Q(有疼痛时为 72.8±18.8,无疼痛时为 78.3±11.2;有抑郁时为 68.2±18.8,无抑郁时为 80.1±12.2)和 DLQI 评分(有疼痛时为 12.1±8.1,无疼痛时为 3.9±3.4;有抑郁时为 10.3±7.1,无抑郁时为 7.4±8.0)。为优化患者体验,应单独考虑不可改变的关联,并且可能可改变的关联,如对特定提供者的满意度、疼痛和抑郁,可作为管理目标。