“Patient-centered treatment” for mild-to-moderate psoriasis

Abstract

People with mild-to-moderate psoriasis have an impaired healthrelated quality of life. Surprisingly, on one hand, at least one-third of these patients are not seeing a physician during episodes of at least 1 year on and average. On the other hand, some patients are seen by the GP and simultaneously by several dermatologists. In this review, we will try to understand this discrepancy between unmet need and medical consumption by reviewing evidencebased data on topical treatments as well as patient reported outcomes and aspects of adherence.In a recent study in patients treated by general practitioners (GPs) in the United Kingdom, awareness of psoriasis, diagnosis, and the options for treatments were low for GPs and their patients. Indeed, it is also our impression that continuous long-term control of mild-to-moderate psoriasis by the GP's is not adequate in all patients, which they have referred to us. In particular, the limitations of chronic exposure to (super)potent corticosteroids, treatment adherence, and the expectations of the patients have to be reconciled in this respect. In order to provide a high-quality management of patients with mild-to-moderate psoriasis, a ''patient centered approach'' is proposed. This model is based on the following considerations:(1) The step-wise approach in treatment selection.(2) Monitoring adherence factors and patient reported outcome measures in a virtual environment. (3) A virtual treatment environment and a liaison between echelons of care. The present review provides the rationale and propositions for a tentative program using ICT solutions and face-to-face contacts for a patient centered treatment model. Ultimately we will suggest the ''patient-centered approach'', a combination of a virtual treatment environment and faceto-face consultations to improve quality and cost effectiveness of care for patients with mild-to-moderate psoriasis.

Implementing well‐being in the management of psoriasis: An expert recommendation

“…15 This paradigm implies a model of people-centred healthcare (PCHC) and integrated health services, in accordance with the ultimate healthcare goal of restoring patients' well-being and health. 18 In an attempt to provide a comprehensive and personalized care plan to improve patient disease management, 'people-centredness approaches' are increasingly gaining prominence in policy, research and general healthcare practice, [19][20][21][22][23] (and particularly in dermatology) [24][25][26] reflected in practice in different national initiatives. [27][28][29][30] However, initiatives such as the Global Psoriasis Atlas have demonstrated a wide variation in the approach to healthcare of patients with psoriasis, with different stakeholders, decision-making and pharmacological approaches globally.…”

Characterizing Outcomes and Unmet Needs Among Patients in the United States with Mild-to-Moderate Plaque Psoriasis Using Prescription Topicals

“…The joint American Academy of Dermatology and National Psoriasis Foundation treatment and management guidelines recommend topical therapies for PSO not involving intertriginous areas [ 11 ]. However, topical treatments can be time-consuming and inconvenient to use, and patients may experience side effects, including stinging, burning, pruritis, irritation, and edema [ 8 , 11 – 13 ]. Furthermore, topical treatments provide relief from the localized symptoms but do not affect underlying systemic inflammatory pathways [ 14 ].…”

“…Furthermore, topical treatments provide relief from the localized symptoms but do not affect underlying systemic inflammatory pathways [ 14 ]. There is limited evidence regarding the impact of topical treatments on the nature of the disease in terms of providing lasting improvement or consistent reduction of symptoms [ 13 ].…”