Health-Related Quality-of-Life Assessment in Dermatologic Practice: Relevance and Application

Health-related quality of life (HRQoL) is gradually becoming a standard outcome in clinical research and health care management. Nevertheless, application in dermatologic practice is not customary and many practical and attitudinal barriers need to be overcome. To contribute to the discussion on and the implementation of HRQoL assessment in routine dermatologic practice, this article describes (1) why HRQoL assessment is relevant for dermatologic practice, (2) which patients would benefit most from routine HRQoL assessment, and (3) how HRQoL assessment can be applied in clinical practic

Satisfaction with treatment among patients with psoriasis: a web-based survey study

Various psoriasis treatments are currently available: topical therapy, photo(chemo)therapy, oral agents and biologics. Little is known about patients' satisfaction with these treatment options. Moreover, the few available studies show methodological shortcomings. To answer the following questions: firstly, how satisfied are patients with psoriasis with their current treatment and does patients' satisfaction significantly differ between treatment types when controlling for demographic and clinical factors? Secondly, how important are specific domains of satisfaction to patients, and when taking perceived importance into account, which domains merit the most attention in improving quality of care? Members of the two existing Dutch associations for patients with psoriasis were invited to complete a web-based survey, which included a study-specific satisfaction questionnaire. A total of 1293 patients completed the survey (response rate 32%). Overall, patients were moderately satisfied with their current treatment. Patients receiving topical treatment were significantly least satisfied; patients receiving biologic treatment were significantly most satisfied. Overall, patients rated 'treatment effectiveness' as most important, followed by 'treatment safety' and 'doctor-patient communication'. Domains with the highest 'room for improvement' scores were effectiveness of topical therapy, phototherapy and oral agents (but not biologic treatment), convenience of topical treatment and safety of systemic treatments (both oral agents and biologics). From the perspective of patients, biologic treatment is promising. To improve further the quality of psoriasis care, the effectiveness and convenience of topical therapies, the safety of systemic therapies, and doctors' communication skills need to be addresse

Patients with lichen sclerosus experience moderate satisfaction with treatment and impairment of quality of life: results of a cross-sectional study

Background: Although they are considered relevant, little is known about satisfaction with treatment and health-related quality of life (HRQoL) among patients with lichen sclerosus (LS). Objectives: In a cross-sectional study, we aimed to examine (i) satisfaction with treatment, (ii) patient characteristics associated with satisfaction and (iii) HRQoL in Dutch patients with LS. Methods: Members of the Dutch LS Patient Association (n = 750) were invited to complete a web-based survey. We measured satisfaction with treatment with a study-specific questionnaire, and HRQoL with the Skindex-29. We calculated domain scores for symptoms, emotions and functioning, and categorized scores into little, mildly, moderately or severely impaired HRQoL. We used a multiple linear regression analysis to examine whether patient characteristics were associated with treatment satisfaction. Results: In total 303 patients (40·4%) were included. Patients under current treatment (n = 265, 87·5%) were moderately satisfied with their treatment. Patients rated ‘treatment effectiveness’ as most important, although 58 (22%) were dissatisfied with the effectiveness of their current treatment. More impairment on the HRQoL emotions domain and a higher degree of disease severity were both associated with lower satisfaction with treatment and explained in total 13·5% of the variance in treatment satisfaction. On all HRQoL domains, one-third of the patients (range 34·7–38·9%) reported severe impairment. Conclusions: Patients with LS are moderately satisfied with their treatment, and one-third of patients experience severe impairment of HRQoL. To improve dermatological care, we recommend enhancement of doctor–patient communication, information provision and organization, which may be more amenable to change than treatment effectiveness or safety

Consumer Quality Index Chronic Skin Disease (CQI-CSD): a new instrument to measure quality of care from the patient's perspective

Assessing quality of care from the patient's perspective is considered to be highly relevant. As a standardized instrument in dermatology was lacking, we developed a patient experience questionnaire regarding chronic skin disease care: the Consumer Quality Index Chronic Skin Disease (CQI-CSD). (i) To evaluate the dimensional structure of the CQI-CSD, (ii) to assess its ability to distinguish between hospitals according to patients' experiences with quality of care, (iii) to explore patients' experiences with dermatological care and priorities for quality improvement according to the patients, and (iv) to optimize the questionnaire based on psychometric results and stakeholders' input. In a cross-sectional study 5647 adult patients who received dermatological care in the past 12 months in 20 hospitals were randomly selected and invited to fill out the questionnaire. Overall 1160 of 3989 eligible respondents (29% response rate, 30-87 per hospital) were included for analysis. The CQI-CSD comprised seven scales with high internal consistency (Cronbach's α = 0·74-0·92). The instrument's discriminative power was limited. Patients were positive about the care provided by nurses and doctors, but the provision of information by healthcare providers, accessibility of care and patient involvement could be improved. We optimized the CQI-CSD, resulting in a revised questionnaire containing 65 items. In conclusion, the CQI-CSD is a useful instrument to measure patient experiences with dermatological car

Quimp (quality of life impairment):an addition to the quality of life lexicon

There has been a constant growth in the number of publications each year concerning "quality of life (QoL)" and "dermatology," since the publication of the Dermatology Life Quality Index in 1994. Numerous dermatology and disease-specific QoL instruments have since been created. Quality of life is frequently assessed in clinical trials, educational activities and epidemiologic studies. QoL assessment is included in many national guidelines in dermatology. QoL assessment scores, together with disease severity measures, are used as guideline criteria for the use of biologics in dermatology and other clinical fields in many countries, and even for treatment reimbursement decisions. QoL assessment in dermatology is considered of benefit for routine clinical use. The European Academy of Dermatology and Venereology Task Force on QoL and Patient Oriented Outcomes (PO) is actively working to facilitate appropriate use of This article is protected by copyright. All rights reserve

Update richtlijn psoriasis 2017

The update of the NVDV guideline psoriasis 2017 is summarized. In the update the chapters methotrexate, fumaric acid esters, biologics, children, serum concentrations and antibody formation and quality of life are renewed. In addition chapters on secukinumab, apremilast, choice of treatment, combination treatment, psoriatic arthritis and pregnancy and breastfeeding during biologic treatment have been added. The update is based on the NVDV guideline psoriasis 20111, European Dermatology Forum (EDF) guideline Psoriasis 20152 and new search and analyses by the workgroup. The most important differences in the update 2017 compared to the NVDV guideline psoriasis 2011 are discussed