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05-08-2010 | Dermatology | Article

Psoriasis patients need better education to self-manage effectively


Free abstract

MedWire News: More systematic educational interventions are needed for patients with mild-to-moderate psoriasis in order for them to effectively self-manage their condition, UK research suggests.

Self-management is key in the management of long-term conditions such as psoriasis, but the current findings reveal that, despite the efficacy of topical treatments, many patients do not persist with them because they have not been adequately informed about their disease and how to treat it effectively.

Steven Ersser, from Bournemouth University, and colleagues say that this "highlights the importance of a negotiated concordance process to improve treatment adherence in which health professionals should take account during consultation of a participant's preferences and beliefs about treatment, and expectations about the time treatments take to have an effect, and their lifestyle situation."

In their qualitative investigation, six focus groups were used to collect data from 22 patients who had suffered with mild-to-moderate psoriasis for an average of 32 years. All patients were using topical treatments, but most used them intermittently and erratically, largely due to a lack of knowledge about the potential benefits of consistent use, and because regimens were frequently devised without input from health services.

Many of the patients, who were managed in primary care and had an average age of 61 years, reported receiving virtually no information or demonstration about the correct use of prescribed topical treatments, and practitioners were thought to lack understanding about the quality-of-life-impact of psoriasis.

The main comments cited by patients in support of self-management were that they felt they were best placed to manage their own condition but that they needed sufficient education and support in order to this well.

The report states that as many patients had had limited success with topical treatment, receiving evidence of the effectiveness of topical therapies and the range of treatments available, as well as clear instructions on how to use them, would be beneficial.

The patients also stressed the need for personalized plans that would fit in with their daily lives and took into account any lifestyle constraints.

In terms of receiving education and information, the patients agreed that this was best given by an "interested and knowledgeable" practitioner. However, supporting written and audiovisual information was also welcomed, as was the opportunity to share "tips" with other patients.

Ersser and team conclude that their data "demonstrate that participants have clear educational expectations and future studies should aim to develop resource-efficient, individualized, person-centred, and systematic educational programs that enable patients to develop the knowledge, skills, and confidence to self-manage effectively."

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Lucy Piper