Department of Dermatology, Tokyo Medical University, Tokyo, Japan.
Eli Lilly Japan KK, Kobe, Japan.
Curr Med Res Opin. 2021 Jul;37(7):1103-1109. doi: 10.1080/03007995.2021.1920898. Epub 2021 May 19.
High treatment satisfaction in both patients and physicians is an important factor in improving quality of life in psoriasis patients. This study aimed to evaluate treatment satisfaction alignment between psoriasis patients and physicians and to identify factors associated with satisfaction misalignment, especially "physician-predominant" misalignment.
This is a nationwide multicenter cross-sectional study. Subjects were paired moderate to severe psoriasis outpatients and their physicians. Treatment satisfaction was evaluated on a scale from 0 to 10. Subjects were defined as "misaligned" when the difference in treatment satisfaction was over ±1 between the patient-physician pair.
A total of 425 pairs were collected from 54 facilities in Japan. The mean patient age and disease duration were 56.5 years and 18.7 years, respectively. The mean physician age was 50.6 years and 69.6% of physicians specialized in psoriasis. Treatment satisfaction misalignment was found in 49.9% of the patient-physician pairs. Among misaligned pairs, 43.6% were "physician-predominant" pairs. In the multivariate logistic regression analyses, "treatment is effective" was the most important reason for treatment satisfaction (odds ratio [OR]: 35.5; 95% confidence interval [CI]: 5.43, 231.78). Symptoms in the genital area (OR: 10.2; 95% CI: 2.55, 40.93) and lack of understanding of treatment options by patients (OR: 7.5; 95% CI: 2.19, 25.94) were key factors leading to "physician-predominant" status.
The results suggest that genital psoriasis plays an important role in treatment satisfaction from the patient perspective, and illustrate the importance of communication between patients and physicians which potentially resolves these factors and improves misalignment.
患者和医生均对治疗高度满意是改善银屑病患者生活质量的重要因素。本研究旨在评估银屑病患者和医生的治疗满意度是否一致,并确定与满意度不一致相关的因素,尤其是“医生主导”的不一致。
这是一项全国多中心横断面研究。研究对象为中重度银屑病门诊患者及其医生。采用 0-10 分的评分来评估治疗满意度。当患者-医生对之间的治疗满意度差值超过±1 时,定义为“不一致”。
本研究共从日本 54 家医疗机构收集了 425 对患者-医生。患者的平均年龄和疾病病程分别为 56.5 岁和 18.7 年,医生的平均年龄为 50.6 岁,69.6%的医生为银屑病专科医生。49.9%的患者-医生对存在治疗满意度不一致。在不一致的对中,43.6%为“医生主导”的对。在多变量逻辑回归分析中,“治疗有效”是治疗满意度最重要的原因(优势比[OR]:35.5;95%置信区间[CI]:5.43,231.78)。生殖器部位的症状(OR:10.2;95%CI:2.55,40.93)和患者对治疗方案的理解不足(OR:7.5;95%CI:2.19,25.94)是导致“医生主导”状态的关键因素。
研究结果表明,从患者的角度来看,生殖器银屑病对治疗满意度起着重要作用,这说明了医患沟通的重要性,医患沟通有可能解决这些因素并改善不一致的情况。