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Definition of psoriasis severity in routine clinical care: current guidelines fail to capture the complexity of long-term psoriasis management
- Source :
- British Journal of Dermatology. 179:1385-1391
- Publication Year :
- 2018
- Publisher :
- Oxford University Press (OUP), 2018.
-
Abstract
- Background Assessment of disease severity is an essential component of psoriasis management. Moderate-to-severe disease qualifies for systemic treatment but different definitions are used. Objectives To analyse the impact of different severity definitions for psoriasis in real-world healthcare. Methods Cross-sectional data on 3274 patients with psoriasis from more than 200 dermatology offices and clinics across Germany were analysed for disease severity based on Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI). The proportions of patients having moderate-to-severe disease were determined accordingly. Results The proportion of patients meeting the European consensus criteria for moderate-to-severe psoriasis (PASI AND DLQI > 10) was 14·0%, although 45·3% attained at least PASI OR DLQI > 10. Consideration of all patients on systemic drugs as being 'moderate-to-severe' increased these proportions to 56·9% and 75·2%, respectively. When only PASI > 10 was used, moderate-to-severe disease affected 35·3% and 69·3%, respectively. Conclusions The proportion of patients with psoriasis under dermatological care considered to have moderate-to-severe disease varies considerably according to how the latter is defined, resulting in uncertainty and inequity of access to systemic therapy. We propose an international standardisation in this for the sake of more reliable treatment and healthcare planning.
- Subjects :
- Adult
Male
medicine.medical_specialty
Consensus
Cross-sectional study
Clinical Decision-Making
Medizin
macromolecular substances
Dermatology
Disease
Severity of Illness Index
Systemic therapy
030207 dermatology & venereal diseases
03 medical and health sciences
0302 clinical medicine
Quality of life
Psoriasis Area and Severity Index
Germany
Psoriasis
Severity of illness
medicine
Humans
Aged
business.industry
Dermatology Life Quality Index
Middle Aged
medicine.disease
Long-Term Care
humanities
Cross-Sectional Studies
nervous system
030220 oncology & carcinogenesis
Practice Guidelines as Topic
Quality of Life
Female
Dermatologic Agents
business
Subjects
Details
- ISSN :
- 00070963
- Volume :
- 179
- Database :
- OpenAIRE
- Journal :
- British Journal of Dermatology
- Accession number :
- edsair.doi.dedup.....e80e840fc256d13c912a12846ff00457