Donker G A, Foets M, Spreeuwenberg P, van der Werf G T
Nederlands Instituut voor Onderzoek van de Gezondheidszorg (NIVEL), Utrecht.
Ned Tijdschr Geneeskd. 1998 Jun 13;142(24):1379-83.
To assess changes in incidence of psoriasis and to study changes in the management of psoriasis in general practice after the sending of guidelines on management of psoriasis to general practitioners (GPs) by the NHG.
Secondary data analysis.
Netherlands Institute for Health Care Research (NIVEL), Utrecht, the Netherlands.
Data on the incidence of psoriasis and its management by general practitioners were collected from a file predating the publication of the NHG guideline 'Psoriasis' in 1994, namely the 'Dutch National Survey of General Practice' (NS; 1987/'88), and from a subsequent file, the 'Registration Network Groningen' (RNG; 1995).
In the NS there were 106 new patients with psoriasis (incidence: 1.3/1000/year; 95% confidence interval (95% CI): 1.2-1.4) while in the RNG there were 24 (incidence: 1.2/1000/year; 95% CI: 0.7-1.9). In all, there were 466 psoriasis patients in the NS and 125 in the RNG. The number of referrals to dermatologists was halved in 1995 (7.2%) compared with 1987/'88 (14.4%; p < 0.05). The most frequently prescribed dermatologica in psoriasis was in 1995 corticosteroid group 3 (32.8%; in 1987/'88: 28.5%), but the rise was stronger in corticosteroid group 2 (29.6%; in 1987/'88: 16.0%; p < 0.001) and group 4 (16.0%; in 1987/'88: 8.8%; p < 0.05).
The incidence of psoriasis in general practice had not changed between 1987/'88 en 1995. Referral pattern and prescription shifted towards the guidelines issued by the NHG.
评估银屑病发病率的变化，并研究荷兰卫生保健指南（NHG）向全科医生（GP）发送银屑病管理指南后，全科医疗中银屑病管理方式的变化。
二次数据分析。
荷兰乌得勒支市的荷兰卫生保健研究机构（NIVEL）。
关于银屑病发病率及其在全科医生管理下情况的数据，收集自1994年NHG指南《银屑病》发布之前的一份档案，即《荷兰全科医疗全国调查》（NS；1987/88年），以及一份后续档案《格罗宁根登记网络》（RNG；1995年）。
在NS中有106例银屑病新患者（发病率：1.3/1000/年；95%置信区间（95%CI）：1.2 - 1.4），而在RNG中有24例（发病率：1.2/1000/年；95%CI：0.7 - 1.9）。NS中共有466例银屑病患者，RNG中有125例。与1987/88年（14.4%；p < 0.05）相比，1995年转介给皮肤科医生的人数减半（7.2%）。1995年银屑病中最常开具的皮肤科药物是3级皮质类固醇（32.8%；1987/88年：28.5%），但2级皮质类固醇（29.6%；1987/88年：16.0%；p < 0.001）和4级皮质类固醇（16.0%；1987/88年：8.8%；p < 0.05）的增长更为明显。
1987/88年至1995年期间，全科医疗中银屑病的发病率没有变化。转诊模式和处方朝着NHG发布的指南转变。
