Evaluating practice patterns for managing moderate to severe plaque psoriasis: role of the family physician.

OBJECTIVE: To describe practice patterns for care of Canadian patients with moderate to severe plaque psoriasis. DESIGN: Online survey of a consumer panel. SETTING: Participants were drawn from a population-wide Canadian consumer database. PARTICIPANTS: To be eligible to participate, respondents had to have been diagnosed with plaque psoriasis within the past 5 years, and to have had body surface area involvement of 3% or greater in the past 5 years, or to have psoriasis on a sensitive area of the body (hands, feet, scalp, face, or genitals), or to be currently receiving treatment with systemic agents or phototherapy for psoriasis. MAIN OUTCOME MEASURES: Proportion of respondents with psoriasis managed by FPs and other specialists, psoriasis therapies, comorbidities, and patient satisfaction. RESULTS: Invitations were sent to 3845 panelists with self-reported psoriasis, of which 514 qualified to complete the survey. Family physicians were reported to be the primary providers for diagnosis and ongoing care of psoriasis in all provinces except Quebec. Overall physician care was reported to be satisfactory by 62% of respondents. Most respondents receiving over-the-counter therapies (55%) or prescribed topical therapies (61%) reported that their psoriasis was managed by FPs. Respondents receiving prescription oral or injectable medications or phototherapy were mainly managed by dermatologists (42%, 74%, and 71% of respondents, respectively). Ongoing management of respondents with body surface area involvement of 10% or greater was mainly split between dermatologists (47%) and FPs (45%), compared with rheumatologists (4%) or other health care professionals (4%). Of those respondents receiving medications for concomitant health conditions, treatment for high blood pressure was most common (92%), followed by treatment for heart disease (75%) and elevated cholesterol and lipid levels (68%). CONCLUSION: Patient-reported practice patterns for the diagnosis and management of moderate to severe psoriasis vary among provinces and in primary and secondary care settings.

A Canadian online survey to evaluate awareness and treatment satisfaction in individuals with moderate to severe plaque psoriasis.

BACKGROUND: Psoriasis is a chronic inflammatory disease associated with comorbidities and decreased quality of life. This survey is aimed to better understand the impact of disease on Canadian patients, and to examine awareness and use of available treatment options. METHODS: An online survey was conducted using a consumer panel. Eligible subjects reported diagnoses of psoriasis and moderate/severe/very severe plaque psoriasis within the past 5 years, and either: psoriasis covering ≥ 3% of body surface area; psoriasis on a sensitive area, or current use of systemic and/or phototherapy or light therapy for psoriasis. RESULTS: A total of 514 panelists completed the survey; 65% reported current moderate/severe/very severe psoriasis. Awareness of available treatment options ranged from 98% for prescription topical agents to 75% for photo/light therapy, and < 50% for prescription oral (49%) or injectable (35%) medications. A total of 92% of respondents had been treated with and 61% were currently taking prescription topical agents. Photo/light therapy had been used by 38% and was currently used by 7% of respondents. Prescribed oral medication had been taken by 25% and was currently used by 8%. Few subjects had been treated with injectables in the past (10%) or currently (5%). Overall, 24% of respondents were very satisfied with their current treatment. A total of 63% of respondents taking injectables were very satisfied, compared with 38% of those taking prescribed oral medication and 21% of those receiving photo/light therapy.Conclusions Most respondents with moderate to severe psoriasis were unaware of all treatment options; systemic treatments were not commonly utilized. Treatment satisfaction rates were low, highlighting the need to ensure greater patient education on and use of available therapeutic options.

A Canadian self-administered online survey to evaluate the impact of moderate-to-severe psoriasis among patients.

BACKGROUND: Few population studies of individuals living with psoriasis have been performed in Canada. OBJECTIVE: The objective of this survey was to understand the severity and impact of psoriasis on the lives of Canadian patients. METHODS: An online survey was conducted using a consumer panel. Eligible subjects reported a diagnosis of psoriasis and provided a self-reported level of severity. In addition, subjects had to either (a) have psoriasis covering at least 3% of their body surface area; (b) have psoriasis on a sensitive area of the body; or (c) be currently undergoing treatment for their psoriasis with systemic medication and/or phototherapy. RESULTS: A total of 514 panelists met the inclusion criteria and completed the survey. Current moderate, severe, or very severe psoriasis was reported by 65% of respondents. Nearly all subjects (96%) had psoriasis affecting a sensitive area of the body. At the time of the survey, 18% were taking systemic medication and/or phototherapy. Comorbidities, such as obesity and high blood pressure, were highly prevalent, with 75% of respondents reporting at least one other diagnosis. Data from the SF-8 and Dermatology Life Quality Index instruments indicated that psoriasis negatively impacted quality of life. CONCLUSION: Moderate-to-severe psoriasis places a burden on Canadian patients, some of whom may be receiving suboptimal treatment or treatment not appropriate for the severity of their condition.