Patient satisfaction with treatments for moderate-to-severe plaque psoriasis in clinical practice
Patient satisfaction with treatments for moderate-to-severe plaque psoriasis in clinical practice
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DOI：
10.1111/bjd.12745
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发表时间：
2014-03-01
影响因子：
10.3
通讯作者：
Gelfand, J. M.
中科院分区：
文献类型：
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作者：
Duffin, K. Callis;Yeung, H.;Gelfand, J. M.
背景中重度银屑病患者的治疗满意度尚未进行研究，并使用经验证的工具进行治疗之间的比较。目的评估患者对临床实践中重度银屑病系统和光疗治疗的满意度，并将满意度与疾病严重程度和生活质量指标相关联。方法这是一项对1182例中重度银屑病患者的横断面研究，美国皮肤病临床有效性研究网络中的重度银屑病患者，仅接受局部治疗;口服全身治疗、生物制剂或窄带紫外线B光疗的单药治疗;或生物制剂和甲氨蝶呤联合治疗完成了药物治疗满意度调查问卷第二版。结果接受生物制剂单药治疗的患者中位未校正的总体满意度评分最高，生物制剂-甲氨蝶呤组合或光疗（83.3）;仅接受局部治疗或阿维A的评分最低（66.7）。在完全校正的模型中，与接受甲氨蝶呤单药治疗的患者相比，接受阿达木单抗、依那西普、乌司奴单抗、光疗或阿达木单抗联合甲氨蝶呤治疗的患者的中位总体满意度评分显著升高7.2 - 8.3分，而仅接受局部治疗的患者的总体满意度显著降低8.9分。仅接受局部治疗或接受英夫利西单抗治疗的患者调整后的便利性评分最低。总体满意度分量表与银屑病面积和严重程度指数（rho =-0.36，P <0.001）和皮肤病生活质量指数（rho =-0.47，P <0.001）之间存在中度但显著的相关性。进一步应用治疗满意度测量可以为治疗决策和指南制定提供信息。
Background Treatment satisfaction among patients with moderate-to-severe psoriasis has not been studied and compared across treatments using a validated instrument.Objectives To assess patient-reported satisfaction with systemic and phototherapy treatments for moderate-to-severe psoriasis in clinical practice and to correlate satisfaction with disease severity and quality-of-life measures.Methods This was a cross-sectional study of 1182 patients with moderate-to-severe psoriasis in the Dermatology Clinical Effectiveness Research Network in the U.S.A. Patients receiving either topical therapies only; monotherapy with oral systemic therapies, biologics or narrowband ultraviolet B phototherapy; or combination therapy with biologics and methotrexate completed the Treatment Satisfaction Questionnaire for Medication version II.Results Median unadjusted overall satisfaction scores were highest for patients receiving biologic monotherapies, biologic-methotrexate combinations, or phototherapy (83.3); scores were lowest for those receiving topical therapies only or acitretin (66.7). In fully adjusted models, compared with patients receiving methotrexate monotherapy, those receiving adalimumab, etanercept, ustekinumab, phototherapy or adalimumab with methotrexate had significantly higher median overall satisfaction scores by 7.2-8.3 points, while those receiving topical therapies only had significantly lower overall satisfaction by 8.9 points. Adjusted convenience scores were lowest for patients receiving topical therapies only or infliximab. Modest but significant correlations were found between the overall satisfaction subscale and both the Psoriasis Area and Severity Index (rho = -0.36, P < 0.001) and the Dermatology Life Quality Index (rho = -0.47, P < 0.001).Conclusions Discernible differences were found in treatment satisfaction among therapies, particularly regarding treatment effectiveness and convenience. Further application of treatment satisfaction measures may inform treatment decisions and guideline development.