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04-08-2011 | Psoriasis | Article

Majority of psoriasis patients want involvement in treatment decisions


Free abstract

MedWire News: Study results show that the majority of patients with psoriasis would prefer to be involved in making decisions about their treatment.

Indeed, patients who received information about their treatment options and side-effects were significantly more satisfied than patients who did not, says the research team.

"Educational interventions could help patients with psoriasis, especially those with psoriatic arthritis, play a more active role in managing their disease," suggest Cristina Renzi and colleagues from Istituto Dermopatico dell-Immacolata in Rome, Italy.

"Interventions should also aim at improving the communication skills and working environment of doctors to facilitate shared decision-making," they add, in the journal Clinical and Experimental Dermatology.

The team contacted 276 patients with psoriasis, 240 of whom agreed to participate in the study. Of these, 207 had cutaneous psoriasis (CP) and 33 had psoriatic arthritis (PA).

Participants completed a questionnaire that examined their preferred role in decision-making using a six-point Likert scale. They graded statements such as "I prefer to make the final decision myself".

The questionnaire also evaluated patients' knowledge about their condition and their overall satisfaction with decision-making.

In total, 27.3% and 28.1% of CP and PA patients, respectively, preferred to leave decisions entirely to their doctor, while the remainder wanted to be involved. In particular, 34.5% of CP patients and 28.1% of PA patients wanted to share decisions with the dermatologist, and only 6.2% and 0% of all CP and PA patients, respectively, preferred to make decisions alone.

Knowledge about psoriasis was generally low, report the researchers, with just 17.0% and 21.4% of CP and PA patients, respectively, displaying a level in the top tertile (6 out of 9 correct statements selected) of the knowledge section of the questionnaire.

These gaps in knowledge "can represent a barrier to participation" note Renzi et al.

In contrast, patient satisfaction levels were high, at 62.0% and 65.5% among CP and PA patients, respectively.

Neither participation, nor knowledge, nor satisfaction levels differed significantly between patients with CP and those with PA, remark Renzi and co-authors.

Of note, however, CP patients' satisfaction levels significantly increased when they had an opportunity to express their opinions/doubts to their doctors.

Multivariate analysis, adjusted for factors including diagnosis of CP or PA, showed that both information on treatment options, and on side-effects, were significantly associated with patient satisfaction in the cohort, increasing it by 3.2- and 5.1-fold, respectively.

The likelihood that patients preferred an active role in their treatment also significantly increased with their knowledge about treatments, the researchers report.

MedWire ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Sarah Guy

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