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Patients' demographic and socioeconomic characteristics influence the therapeutic decision-making process in psoriasis.

ABSTRACT: BACKGROUND:Knowledge regarding differences in care for psoriatic patients is limited. The aim of this study was to investigate factors influencing prescription of systemic treatments for patients with psoriasis with a special focus on socioeconomic factors. METHODS AND FINDINGS:This was a non-interventional, cross-sectional study, conducted in 18 Italian University and/or hospital centers with psoriasis-specialized units. Questionnaires evaluating demographic and socioeconomic characteristics were administered to participants. Overall, 1880 consecutive patients affected by mild-to-severe psoriasis were recruited. Univariate and multivariable logistic regression analyses of systemic therapy prescription, with a special focus on biologics, accounting for the above mentioned characteristics were performed. Our analysis showed that all analyzed patients' characteristics were significantly associated with biological therapy compared to non-biological systemic one. Particularly, women were less likely to receive biologics than men (OR = 0.66; 95% CI, 0.57-0.77). Elderly patients (?65 years) and subjects with a BMI ?30 had lower odds to receive biologics respect to adults (?35-64 years) (OR = 0.33; 95% CI, 0.25-0.40), and subjects with BMI?25<30 (OR = 0.64; 95% CI, 0.53-0.77), respectively. Northern and Southern patients were both less likely to receive biologics than Central patients (OR = 0.75; 95% CI, 0.63-0.89, and OR = 0.56; 95% CI,0.47-0.68, respectively). Lower economic profile and never reading books were both associated with decreased odds of receiving biological therapy. CONCLUSIONS:This study shows that sex, age, comorbidities, and socioeconomic characteristics influence the prescription of systemic treatments in psoriasis, highlighting that there are still unmet needs influencing the therapeutic decision-making process that have to be addressed.

SUBMITTER: Scala E

PROVIDER: S-EPMC7423114 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Patients' demographic and socioeconomic characteristics influence the therapeutic decision-making process in psoriasis.

Scala Emanuele E Megna Matteo M Amerio Paolo P Argenziano Giuseppe G Babino Graziella G Bardazzi Federico F Bianchi Luca L Caldarola Giacomo G Campanati Anna A Cannavò Serafinella Patrizia SP Chiricozzi Andrea A Conti Andrea A Damiani Giovanni G Dapavo Paolo P De Simone Clara C Esposito Maria M Fabbrocini Gabriella G Fargnoli Maria Concetta MC Ferrara Francesca F Fidanza Rosaria R Gualdi Giulio G Guarneri Claudio C Hansel Katharina K Malagoli Piergiorgio P Malara Giovanna G Micali Giuseppe G Mugheddu Cristina C Musumeci Maria Letizia ML Odorici Giulia G Offidani Annamaria A Pescitelli Leonardo L Prignano Francesca F Raimondo Annunziata A Ribero Simone S Rongioletti Franco F Stingeni Luca L Trifirò Caterina C Zanframundo Salvatore S Balato Anna A

PloS one 20200812 8

<h4>Background</h4>Knowledge regarding differences in care for psoriatic patients is limited. The aim of this study was to investigate factors influencing prescription of systemic treatments for patients with psoriasis with a special focus on socioeconomic factors.<h4>Methods and findings</h4>This was a non-interventional, cross-sectional study, conducted in 18 Italian University and/or hospital centers with psoriasis-specialized units. Questionnaires evaluating demographic and socioeconomic cha ...[more]

PMID: 32785291

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Project description:BackgroundTo assess factors associated with the preferred role of the attending ophthalmologist in the decision-making processes before treating diabetic retinopathy (DR).MethodsCross-sectional study of 810 adults attending secondary diabetes care centers (NCT02311504). Diabetes patients were classified using a validated questionnaire in an ophthalmologist-dominant decision-making (ODM), shared decision-making (SDM) and patient-dominant decision-making (PDM) style. Multivariate logistic regression was performed to determine factors associated with the decision-making process.ResultsA majority of 74.3% patients preferred SDM between ophthalmologist and patient, 17.4% patients wanted ODM, delegating the decision-making process to the ophthalmologist, 8.3% preferred the autonomous style of PDM. Patients wanting ODM were older (OR = 1.2 per decade, p = 0.013), had a lower level of education (OR = 1.4, p = 0.001) and had a higher frequency of consultations per year (OR = 1.3, p = 0.022). Patients with better basic knowledge in DR and memorizing their HbA1c level showed a higher propensity for SDM (OR = 1.1, p = 0.037). Patients wanting PDM had a significantly higher education (OR = 1.3, p = 0.036) and a greater desire for receiving information from self-help groups (OR = 1.3, p = 0.015).ConclusionsThe first evaluation of the general patient wishes for the treatment of DR confirmed the concept of SDM, which was favored by three quarters. In particular, older patients with low educational attainment wanted to delegate the decision-making process to the ophthalmologist. Amelioration of ophthalmologic education in diabetic programs might take up patients' propensity for SDM. Regardless of the decision-making group, nearly all patients wanted the medical and scientific information to be transferred by and shared with the ophthalmologist.Trial registrationThe study was registered on www.clinicaltrials.gov (identifier: NCT02311504) on December 4th 2014.

Dataset Information

Patients' demographic and socioeconomic characteristics influence the therapeutic decision-making process in psoriasis.

Publications

Patients' demographic and socioeconomic characteristics influence the therapeutic decision-making process in psoriasis.

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