Rajagopalan Murlidhar, Dogra Sunil, Godse Kiran, Kar Bikash Ranjan, Kotla Sai Krishna, Neema Shekhar, Saraswat Abir, Shah Swapnil Deepak, Madnani Nina, Sardesai Vidyadhar, Sekhri Rajiv, Varma Sachin, Arora Sandeep, Kawatra Pallavi
Department of Dermatology, Apollo Hospital, Chennai, India.
Department of Dermatology Venereology & Leprology Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh, 160012, India.
Psoriasis (Auckl). 2022 Aug 25;12:221-230. doi: 10.2147/PTT.S375173. eCollection 2022.
The primary objective of the study was to understand the therapeutic inertia in treatment and management of plaque psoriasis among dermatologists, along with determining the preferred treatment choices for management of plaque psoriasis; it also included the resulting treatment satisfaction among patients. The secondary objective was to identify the gaps in terms of knowledge and attitude among dermatologists and the expectations of patients.
A multicentre, cross-sectional quantitative survey was conducted among dermatologists and patients with moderate to severe plaque psoriasis across India. The interviews were conducted either face to face or via telephone between September and November 2020, using structured and validated questionnaires based on specific themes. The data obtained were statistically analysed, wherever applicable.
Overall, 207 adult patients with moderate-to-severe plaque psoriasis and 303 dermatologists were interviewed. Post experiencing symptoms, 44% of the patients visited general physicians for treatment and there was an average 7.8-month delay by the patients to consult a dermatologist. Approximately one-fourth of patients used home remedies before seeking medical help. One-third of dermatologists used the Psoriasis Area and Severity Index (PASI) for assessing the disease severity. Majority of dermatologists preferred combination therapy for their patients. The lack of quick resolution and side effects were the major reasons for changing the treatment. Overall, only 35% of the patients complied to current treatment. Satisfaction with existing forms of therapies was highest for mild plaque psoriasis (62%) as confirmed by dermatologists, while 52% of the overall patients were satisfied with their therapy. Majority of the patients (64%) affirmed living with plaque psoriasis impacted their lives.
This first-of-its-kind survey in India highlighted the gaps in terms of the disease journey between dermatologists and patients. The survey emphasises the need for shared decision-making and may benefit dermatologists in suggestive modifications of the treatment algorithm and disease management in clinical settings.
本研究的主要目的是了解皮肤科医生在斑块状银屑病治疗和管理中的治疗惰性，同时确定斑块状银屑病管理的首选治疗方案；研究还包括患者由此产生的治疗满意度。次要目的是找出皮肤科医生在知识和态度方面的差距以及患者的期望。
在印度各地的皮肤科医生和中重度斑块状银屑病患者中进行了一项多中心横断面定量调查。2020年9月至11月期间，采用基于特定主题的结构化且经过验证的问卷，通过面对面或电话方式进行访谈。所获数据在适用时进行统计分析。
总体而言，共访谈了207例中重度斑块状银屑病成年患者和303名皮肤科医生。出现症状后，44%的患者前往全科医生处治疗，患者咨询皮肤科医生的平均延迟时间为7.8个月。约四分之一的患者在寻求医疗帮助前使用过家庭疗法。三分之一的皮肤科医生使用银屑病面积和严重程度指数（PASI）评估疾病严重程度。大多数皮肤科医生倾向于为患者采用联合治疗。治疗缺乏快速缓解和副作用是改变治疗的主要原因。总体而言，只有35%的患者依从当前治疗。皮肤科医生证实，轻度斑块状银屑病患者对现有治疗方式的满意度最高（62%），而总体患者中有52%对其治疗感到满意。大多数患者（64%）确认斑块状银屑病影响了他们的生活。
印度的这项首例调查凸显了皮肤科医生和患者在疾病诊疗过程中的差距。该调查强调了共同决策的必要性，可能有助于皮肤科医生在临床环境中对治疗算法和疾病管理进行有针对性的调整。
