THE EUROPSO PSORIASIS PATIENT STUDY THE EUROPSO PSORIASIS PATIENT STUDY: TREATMENT HISTORY AND SATISFACTION REPORTED BY 17,990 MEMBERS OF EUROPEAN PSORIASIS PATIENT ASSOCIATIONS
Salonen S-H on behalf of the EUROPSO Patient Survey Study Group EUROPSO, Helsinki, Finland INTRODUCTION
respondents with psoriasis see a dermatologist
The fact that therapy is time-consuming was
Psoriasis can have a profound impact on a
reported by 50% of respondents as the mosttroublesome aspect of treatment, followed by
person’s quality of life, particularly if it is
respondents diagnosed with psoriatic arthritis
ineffectiveness (32%). A higher proportion of
extensive, affects a visible or sensitive area, or
respondents with severe psoriasis reported side
is difficult to treat. To explore the impact of
PSORIASIS TREATMENT AND
effects to be a problem of treatment than those
psoriasis on the quality of life of European
with mild psoriasis (31% vs 23%, respectively)
patients and to learn about patients’ perceptions
SATISFACTION
(Figure 3). Respondents with psoriatic arthritis
Forty percent of respondents were currently
Federation of Psoriasis Patient Organisations)
using some form of prescription medication. Of
troublesome aspect of treatment. Forty percent
has conducted a large-scale postal survey of the
these, approximately 40% were using a topical
of all respondents, and 41% with severe psoriasis
members of nine European patient associations.
treatment (e.g. vitamin D analogue, steroids or
were not currently using any prescription
coal tar) and approximately 20% a systemic
treatment. A large number respondents were
treatment. 13% were currently using some form
currently using some form of “alternative”
A total of 50,500 survey questionnaires were
treatment, with 37% currently using an OTC
directly mailed to the members of participating
medication or treatments such as diet, herbs,
psoriasis patient organisations or distributed
acupuncture relaxation techniques or baths, and
via participating dermatologists in Belgium,
Figure 1. Use of prescription
8.4% were currently using some form of thermal
Czech Republic, Finland, France, Germany, Italy
medications
and The Netherlands between March and April2002. The response cut-off date was August 16
PRESCRIPTION MEDICATIONS
Figure 3. Problems associated with treatmentCONCLUSIONS QUESTIONNAIRE DESIGN NEGATIVE ASPECTS OF PSORIASIS TREATMENT
The questionnaire design was developed in
collaboration with the National Psoriasis
Foundation (NPF) of the United States, following
the design of recent questionnaires to enable
comparisons of the results. The self-administered
questionnaire included sections on type of
psoriasis, self-reported severity, symptoms,
Fumarates Calcipotriene opical ster Antimalarials Sulfasalazine
history and current use of psoriasis treatments,
Ineffective Expensive Unpleasant
as well as a validated psoriasis quality of life
consuming
scale, the Psoriasis Disability Index (PDI).
Respondents provided their perceptions ongeneral satisfaction with the treatment of their
CONCLUSIONS
psoriasis or psoriatic arthritis, as well as
satisfaction with prescription treatments using
• This survey is the largest survey of people
A total of 18,386 responses were received,
a 1 to 10 scale, with 1 being “very unsatisfied”
representing an overall response rate of 36.4%.
and 10 “very satisfied”. Overall, approximately
responses from 7 European countries.
Of all respondents 17,990 stated they had
• The results of this survey appear to be
psoriasis, 49.1% were male and 50.9% female.
expressed low or only moderate satisfaction
The majority (97%) were of Caucasian race and
with psoriasis treatment (score of 1-7), with
conducted amongst people with psoriasis.
had completed some further education (57%).
27% expressing high satisfaction (score of 8-10)
• 17,990 respondents had psoriasis, with 30%
The mean age of onset of psoriasis was 30.5
of respondents having been diagnosed with
years, with a mean duration of 23 years. Three-
quarters (75%) of patients had chronic plaque
Figure 2. Satisfaction with psoriasis
• Satisfaction with current treatments is low,
treatment
and many respondents consideredtreatment to be time-consuming and/or
The severity of psoriasis was self-reported, with
PATIENT SATISFACTION
respondents equating the area of a palm to
How satisfied have you been concerning the treatment for your psoriasis?
• 21% of respondents are not currently seeing
represent 1% body surface area. Overall, 9% of
a healthcare professional for their psoriasis.
respondents reported little involvement of
psoriasis, 32% reported mild psoriasis (1-2% of
Further analysis of the results of this survey
the body covered), 42% moderate psoriasis (3-
10% covered), and 17% severe psoriasis with
patients’ perspectives on the psychosocial
more than 10% of the body covered. Therefore,
impact of psoriasis and the effectiveness of
59% of respondents could be classified with
Moderate
moderate-to-severe psoriasis. Severity did notappear to be strongly related to either age of
onset, duration of psoriasis or gender. Thirty
prescription treatments, higher satisfaction
EUROPSO is a federation of psoriasis patient
percent of respondents stated that they had
(score of 8-10) was expressed for the systemic
associations in Europe. It aims to raise awareness of
been diagnosed with psoriatic arthritis by a
therapies methotrexate (30%), cyclosprine (28%)
psoriasis and achieve equal opportunities for psoriasis
and fumarates (26%), as well as PUVA treatment
patients in all European countries through active supportof its member associations.
A total of 21% of respondents stated that they
(38%). Lower satisfaction (score of 1-4) was
were not currently consulting a healthcare
expressed for tazarotene and etretinate (42%
EUROPSO would like to thank Biogen for an
professional. Of those seeking care, 58% of
unrestricted educational grant in support of this survey.
of the authors and THE JOURNAL and not those of High-Dose Statins in Acute Coronary Syndromes Not Just Lipid Levels Steven E. Nissen, MD statin clinical trial literature. Two other trials in ACS pa- tients showed safety and efficacy ( TABLE ). The Myocardial FORMORETHANADECADE,STATINDRUGSHAVEACCU- IschemiaReductionwithAggessiveCholesterolLoweringmulated a remarkable record of successful clini
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