Psoriasis Severity, Health-Related Quality of Life, Work Productivity, and Activity Impairments Among Patients With Moderate to Severe Psoriasis Receiving Systemic Treatment: Real-World Data From Clinical Practice in Spain. / [Artículo traducido] Gravedad de la psoriasis, calidad de vida relacionada con la salud, productividad laboral y deterioro de la actividad en pacientes con psoriasis moderada a grave que reciben tratamiento sistémico: datos de la vida real de la práctica clínica en España.

BACKGROUND AND OBJECTIVE: The treatment of psoriasis should not only focus on skin affectations but also weigh the parameters for health-related quality of life (HRQoL), thereby tackling the concept of cumulative life course impairment (CLCI) and treating the patient from a holistic perspective. The CRYSTAL study aimed to characterize psoriasis with real-word data from Spanish clinical practice in patients with moderate to severe disease who received continuous systemic treatment for at least 24 weeks by using the absolute Psoriasis Area and Severity Index (PASI) score and its correlation to HRQoL. MATERIAL AND METHODS: This was a non-interventional, cross-sectional study conducted in 30 centers in Spain, with 301 patients between the ages of 18 and 75 years. The study collected data regarding current treatment and absolute PASI and their relationship to HRQoL using the Dermatology Life Quality Index (DLQI), to activity impairment using the Work Productivity and Activity Impairment (WPAI) questionnaire, and to treatment satisfaction. RESULTS: The mean (SD) age was 50.5 (12.5) years, with a duration of disease of 14 (14.1) years. The mean (SD) absolute PASI reported was 2.3 (3.5), with 28.7% of patients presenting with PASI from >1 to ≤3 and 22.6% with PASI>3. Higher PASI scores were associated with higher DLQI (p<0.001) and WPAI scores and lower levels of treatment satisfaction (p<0.001). CONCLUSIONS: These data indicate that achieving lower absolute PASI values may correlate not only with better HRQoL but also with better work productivity and treatment satisfaction.

Psoriasis Severity, Health-Related Quality of Life, Work Productivity, and Activity Impairments Among Patients With Moderate to Severe Psoriasis Receiving Systemic Treatment: Real-World Data From Clinical Practice in Spain.

BACKGROUND AND OBJECTIVE: The treatment of psoriasis should not only focus on skin affectations but also weigh the parameters for health-related quality of life (HRQoL), thereby tackling the concept of cumulative life course impairment (CLCI) and treating the patient from a holistic perspective. The CRYSTAL study aimed to characterize psoriasis with real-word data from Spanish clinical practice in patients with moderate to severe disease who received continuous systemic treatment for at least 24 weeks by using the absolute Psoriasis Area and Severity Index (PASI) score and its correlation to HRQoL. MATERIAL AND METHODS: This was a non-interventional, cross-sectional study conducted in 30 centers in Spain, with 301 patients between the ages of 18 and 75 years. The study collected data regarding current treatment and absolute PASI and their relationship to HRQoL using the Dermatology Life Quality Index (DLQI), to activity impairment using the Work Productivity and Activity Impairment (WPAI) questionnaire, and to treatment satisfaction. RESULTS: The mean (SD) age was 50.5 (12.5) years, with a duration of disease of 14 (14.1) years. The mean (SD) absolute PASI reported was 2.3 (3.5), with 28.7% of patients presenting with PASI from >1 to ≤3 and 22.6% with PASI>3. Higher PASI scores were associated with higher DLQI (p<0.001) and WPAI scores and lower levels of treatment satisfaction (p<0.001). CONCLUSIONS: These data indicate that achieving lower absolute PASI values may correlate not only with better HRQoL but also with better work productivity and treatment satisfaction.

[Triage area. Use and effectiveness of a protocol]. / Area de "triage". Utilidad y eficacia de un protocolo.

In the Organization of the urgency services, there's a general agreement about need to have a triage system or a first classification of the patient at their arrival, for a quick, ordered, and directed access, attending the dangerously wounded patient with priority, acting like a true filter of the dangerously wounded patient. This is a function realized in The Juan Ramon Jimenez Hospital by nurses in the triage area. Patient is classified into these groups, determining of this way the priority of their attention, basing in the triage protocol: I: emergency or vital risks. II: acute processes, critical. III: acute processes, no critical. IV: banal processes, no urgent. The objective of this study is to evaluate the utility and efficacy of the nurse triage protocol from the valuation of different nurses, compiling data of 300 clinic histories, taking as indicative or evaluations, the degree of homogeneity of the differents triages realized. We take from a comparative description study of a total of 300 cases, being cassified in a continuous way by two nurses in different areas. To emphasize, that of the total of the studied population, the percentage of patients that have been classified with the same gravity level by both nurses, is about the 95.9%, being located the not coincidences, always in levels iii and iv. the 99.7% of these patients have been derived to the same speciality atter their triage. The specialities that sustain greater assistance demand are internal medicine and traumatology, with a 41.7% and a 34.3% respectively. The total of studied cases, 75% attend to the urgency service by own petition, which 86% are catalogued as level iv (banal processes), 23.4% are transmitted by urgency services or provide p10, being only a 20% of theses cases considered as acute processes, that it supposes a 4.6% of the total and a 1.3% are transferred by e.p.e.s 061, being the 100% defined as acute processes. The group of age that demand more sanitary assistance is between 20 and 40 years, prevailed the masculine sex in all the groups, except in those greater of 60 years, where the women exceed them in a 23.6%.