‘I should have taken that further’ – missed opportunities during cardiovascular risk assessment in patients with psoriasis in<scp>UK</scp>primary care settings: a mixed‐methods study

Nelson, Pauline; Kane, Karen; Chisholm, Anna; Pearce, Christina; Keyworth, Chris; Rutter, Martin K.; Chew‐Graham, Carolyn; Griffiths, C.E.M.; Cordingley, Lis

doi:10.1111/hex.12404

Cited by 30 publications

(39 citation statements)

References 68 publications

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“…Cardiovascular risk factor screening is a means of identifying a high proportion of patients at high CVD risk, with screen‐detected risk factors and with suboptimally managed known risk factors. However, these findings need to be considered alongside those showing the limited response of clinicians to identified risk before universal CVD screening for people with psoriasis can be recommended …”

Section: Discussionmentioning

confidence: 99%

Primary care‐based screening for cardiovascular risk factors in patients with psoriasis

et al. 2016

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SummaryBackgroundStudies assessing cardiovascular disease (CVD) risk factors in patients with psoriasis have been limited by selection bias, inappropriate controls or a reliance on data collected for clinical reasons.ObjectivesTo investigate whether screening for CVD risk factors in patients with psoriasis in primary care augments the known prevalence of CVD risk factors in a cross‐sectional study.MethodsPatients listed as having psoriasis in primary care were recruited, screened and risk assessed by QRISK2.ResultsIn total, 287 patients attended (mean age 53 years, 57% women, 94% white British, 22% severe disease, 33% self‐reported psoriatic arthritis). The proportion with known and screen‐detected (previously unknown) risk factors was as follows: hypertension 35% known and 13% screen‐detected; hypercholesterolaemia 32% and 37%; diabetes 6·6% and 3·1% and chronic kidney disease 1·1% and 4·5%. At least one screen‐detected risk factor was found in 48% and two or more risk factors were found in 21% of patients. One in three patients (37%) not previously known to be at high risk were found to have a high (> 10%) 10‐year CVD risk. Among the participants receiving treatment for known CVD risk factors, nearly half had suboptimal levels for blood pressure (46%) and cholesterol (46%).ConclusionsCardiovascular risk factor screening of primary care‐based adults with psoriasis identified a high proportion of patients (i) at high CVD risk, (ii) with screen‐detected risk factors and (iii) with suboptimally managed known risk factors. These findings need to be considered alongside reports that detected limited responses of clinicians to identified risk factors before universal CVD screening can be recommended.

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Section: Discussionmentioning

confidence: 99%

Primary care‐based screening for cardiovascular risk factors in patients with psoriasis

et al. 2016

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“…Patients’ general knowledge of psoriasis is known to be low, especially knowledge related to the role of comorbidities . Efficacious psoriasis care may require HL skills such as collaborative communication with healthcare providers, taking an active part in shared‐decision making, and participation in self‐management and goal setting . However, people with HL weaknesses may lack the skills to accomplish such tasks and find it difficult to access and understand healthcare information and implement the recommended behaviours.…”

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confidence: 99%

Health literacy: a new piece of the puzzle in psoriasis care? A cross‐sectional study

Larsen¹,

Strumse

Borge³

et al. 2019

Br J Dermatol

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Summary Background Health literacy (HL) – the ability to seek, understand and utilize health information – is important for good health. Suboptimal HL has been associated with poorer health outcomes in other chronic conditions, although this has not previously been studied in patients with psoriasis. Objectives To investigate the HL strengths and weaknesses of a cohort of patients with moderate‐to‐severe psoriasis. Another aim was to examine possible associations between patients’ quality of life, their demographic, clinical and self‐management characteristics, and dimensions of HL. Methods A cross‐sectional study was conducted. Data were collected from a cohort of patients with psoriasis who had received climate helio therapy from 2011 to 2016 (n = 825). HL was assessed by the Health Literacy Questionnaire (HLQ). The association between HL domains, demographic, clinical and self‐management variables were analysed using bivariate correlation and a four‐step linear multiple regression model. Results The scores on all HLQ dimensions indicated lower health literacy than other populations. The linear regression models showed a significant association between HL, quality of life and self‐management variables, with higher HL predicting higher quality of life, self‐efficacy and psoriasis knowledge. Sex, educational attainment, age and disease severity had less influence on health literacy. Conclusions Improving HL may be a useful strategy for reducing disparities in self‐management skills for patients with psoriasis. Interventions that aim to reduce disease severity and increase psoriasis knowledge, self‐efficacy and quality of life may positively increase HL.

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“…A hot‐water mycelial extract, called lentinan, has been widely used as a preventive and therapeutic agent for cancer patients in Japan and China . It is a polysaccharide with β‐1,3‐linked glucose backbone and β‐1,6‐linked glucose branches . Lentinan shows beneficial effects in DSS‐induced acute colitis mouse model because of its intestinal anti‐inflammatory activity .…”

Section: Introductionmentioning

confidence: 99%

Therapeutic effects of lentinan on inflammatory bowel disease and colitis‐associated cancer

Liu

Zhao

et al. 2018

J Cellular Molecular Medi

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In this study, we investigated the therapeutic potential of lentinan in mouse models of inflammatory bowel disease (IBD) and colitis‐associated cancer (CAC). Lentinan decreased the disease activity index and macroscopic and microscopic colon tissue damage in dextran sulphate sodium (DSS)‐induced or TNBS‐induced models of colitis. High‐dose lentinan was more effective than salicylazosulfapyridine in the mouse models of colitis. Lentinan decreased the number of tumours, inflammatory cell infiltration, atypical hyperplasia and nuclear atypia in azoxymethane/DSS‐induced CAC model. It also decreased the expression of pro‐inflammatory cytokines, such as IL‐13 and CD30L, in IBD and CAC model mice possibly by inhibiting Toll‐like receptor 4 (TLR4)/NF‐κB signalling and the expression of colon cancer markers, such as carcinoembryonic antigen, cytokeratin 8, CK18 and p53, in CAC model mice. In addition, lentinan restored the intestinal bacterial microbiotal community structure in IBD model mice. Thus, it shows therapeutic potential in IBD and CAC model mice possibly by inhibiting TLR4/NF‐κB signalling‐mediated inflammatory responses and disruption of the intestinal microbiotal structure.

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‘I should have taken that further’ – missed opportunities during cardiovascular risk assessment in patients with psoriasis inUKprimary care settings: a mixed‐methods study

Cited by 30 publications

References 68 publications

Primary care‐based screening for cardiovascular risk factors in patients with psoriasis

Primary care‐based screening for cardiovascular risk factors in patients with psoriasis

Health literacy: a new piece of the puzzle in psoriasis care? A cross‐sectional study

Therapeutic effects of lentinan on inflammatory bowel disease and colitis‐associated cancer

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