Age-based treatment differences in and reluctance to treating older adults with systemic antipsoriatic therapy - a mixed-method pilot study.
J Dermatolog Treat
; 33(7): 2983-2990, 2022 Nov.
Article
in En
| MEDLINE
| ID: mdl-35762362
ABSTRACT
BACKGROUND:
Evidence-based guidance in older adults (≥65 years) with psoriasis is sparse and undertreatment might be present.OBJECTIVES:
To assess prescribing patterns, comfort levels, barriers and needs of dermatologists when treating older adults with systemic antipsoriatic therapy.METHODS:
A mixed-methods design was used including a survey among all Dutch dermatologists and residents, followed by semi-structured interviews.RESULTS:
Most of the survey respondents applied systemic treatment to the same extent in older versus younger patients (n = 49; 67.1%) and weren't reluctant prescribing systemic therapy (n = 50; 68.5%) in older adults. However, 26% (n = 19) of the respondents treated older adults less often with systemic therapy compared to younger patients and 68.1% (n = 49) performed additional actions in older adults, e.g. intensified monitoring or dose reduction. Based on the survey and interviews (n = 10), the main reasons for these age-based treatment differences were comorbidity, comedication, and fear of adverse events. More evidence-based guidance, education, and time to assess older adults were identified as most important needs, especially regarding frailty screening.CONCLUSIONS:
Age-based treatment differences in and reluctance to treating older adults with systemic antipsoriatic therapy were common. There is a need for more evidence-based guidance, education, and consultation time, to improve treatment in this growing population.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Psoriasis
/
Dermatologic Agents
Type of study:
Guideline
/
Qualitative_research
Limits:
Aged
/
Humans
Language:
En
Journal:
J Dermatolog Treat
Journal subject:
DERMATOLOGIA
Year:
2022
Document type:
Article
Affiliation country:
Países Bajos