MONDAY, Nov. 21 (HealthDay News) -- Many people with the skin
disease psoriasis put a higher value on a treatment that suits
their lifestyle than on out-of-pocket costs and side effects, a new
German study finds.
As many as 7.5 million Americans have the chronic skin
condition, according to the National Psoriasis Foundation. The most
common type is plaque psoriasis, characterized by raised, red
patches covered with a silvery white buildup of dead skin
Management of the disease can be frustrating, and many patients
object to different facets of treatment, which can involve
light-based therapy, creams, pills or systemic medications given by
injection or intravenously.
Treatment doesn't work if you don't use it, said Dr. Michele
Green, a dermatologist at Lenox Hill Hospital in New York City, who
is familiar with the study. "People want to control their own
destiny. If someone doesn't want to do light therapy or isn't going
to use a cream, we have to talk about other treatments with
Green wasn't surprised by the findings. Convenience counts, she
said. "We have to meet our patients where they are," she added.
Trying to assess patients' priorities regarding treatment,
researchers from the Medical Faculty Mannheim of Heidelberg
University in Mannheim surveyed 163 adults who were treated for
moderate to severe psoriasis from December 2009 to September 2010.
They looked at treatment location -- at home, in the doctor's
office or hospital -- frequency, duration, delivery method and
cost. They also looked at the chance of benefit, and the severity
and likelihood of side effects.
Treatment location was deemed most important, followed by the
chance of benefit and the method of delivery, whether by pill,
cream or injection. Participants also cared more about whether or
not the treatment was going to work than the risk of side effects
or how long the benefit would last, the study showed. Out-of-pocket
costs were not terribly relevant, the researchers found.
Women and singles cared more about the improvement to their skin
than did males and participants in a committed relationship.
The findings are published in the November issue of
Archives of Dermatology.
"Although patients with psoriasis attach significant importance to the probability and magnitude of benefit, it appears that process attributes, such as location and method of delivery of treatment, may be even more important," the researchers concluded. "Incorporating preferences in shared decision making may facilitate treatment adherence and optimize outcome."
Dr. Bruce Strober, an assistant professor of dermatology at the
University of Connecticut School of Medicine in Farmington, agreed.
"All therapies must be tailored to a range of patient-specific
parameters, such as age, gender, personality, comorbid conditions,
work/life schedule, tolerance for risk and economic status," he
said. "Patients should never be shoehorned into a specific modality
of treatment that may not fit well with any or all of these
Psoriasis, which affects both skin and joints, is a debilitating
autoimmune disease, meaning the body's immune system attacks its
own healthy cells. The condition can vary from mild to severe, with
patches affecting more than 10 percent of a person's body in some
The finding that single people care more about their skin's
appearance than those in a relationship mirrors what Green sees in
her practice. "I have had patients that are single cry, and once
they get married, it is not so important," she said.
For more information on psoriasis treatments, visit the
National Psoriasis Foundation.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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