Nadine Franzke

Concordance of the Psoriasis Area and Severity Index (PASI) and patient-reported outcomes in psoriasis treatment

A prospective observational study was conducted to analyze to what extent the Psoriasis Area and Severity Index (PASI) is correlated to patient reported outcomes (PRO). Data were collected on 93 outpatients with psoriasis prior to (t1) and after therapy (t2). A higher PASI score was associated with impaired Quality of Life (DLQI), however associations were only weak (R = 0.24 on t1 and R = 0.36 on t2). The average improvement in PASI score was correlated moderately highly with the change of DLQI (R = 0.50) as well as with the PBI (R = 0.45). The threshold values PASI-50 and PASI-75 were likewise positively associated with PRO, but they only incompletely reflect them: about half of the patients with PASI-50 did not see their expectations met (46.9%) or were not satisfied with the condition of the skin after treatment (56.3%). A quarter of these patients experienced no benefits from the therapy. Of the patients with PASI-75, 15.4% were not satisfied with the condition of their skin. In contrast, 36% of patients who did not attain PASI-50 specified a high level of treatment satisfaction. PASI and PRO are associated but based on different concepts. In addition to clinicial severity, patient-defined benefits should be implemented in the evaluation of psoriasis care.

Efficacy, Tolerability and Patient Benefit of Ultrasound-Assisted Wound Treatment versus Surgical Debridement: A Randomized Clinical Study

Background: Low-frequency ultrasound has been shown to be an alternative to surgical wound debridement (WD) to stimulate wound healing; however, few data are available. Objective: To compare the efficacy, tolerability and benefit of both wound treatment methods. Methods: A monocentric prospective randomized-controlled clinical study assessing patient-reported outcomes and clinical efficacy of ultrasound-assisted wound treatment (UAW) compared to WD. Results: In total, 67 patients were treated. Efficacy and tolerability were found to be good for both treatments, with 88% of UAW and 85.2% of WD patients experiencing more-than-minimal patient benefit. Quality of life improved significantly. Wound status improved and pain decreased in both groups. Conclusion: Compared to the gold standard (i.e. WD), UAW displays the same high efficacy, comparable patient benefit and improved quality of life. Both procedures are equally suitable for highly beneficial guideline-based treatment of chronic wounds.

Quality of health care of atopic eczema in Germany: results of the national health care study AtopicHealth

The successful treatment of atopic eczema (AE) should result in the improvement of both physical symptoms and patient′s quality of life (QoL). This study was conducted using a sample of dermatologists throughout Germany. This is due to dermatologists being the main health care providers of AE.

Health Services Research in Psoriasis – The German Approach

insurance funds and other parties involved in the health care sector have realized the need to obtain specific data on health services provision. The task of health services research is to investigate the reality of health services provision under everyday conditions (German Medical Association 2005). Health services research has established itself as the third pillar of health research – along with biomedical basic research and clinical research. In order to provide a picture of the state of health services provision in Germany, it is necessary to obtain sufficient upto-date national data on the German health care system. Though the development of effective health services research is now regarded as essential, our knowledge of the state of health services provision in Germany is, in some cases, still only rudimentary, even in the case of some of the most common diseases. This is especially true for skin diseases.

Allergies in Germany – prevalence and perception by the public

During the recent decades allergies have become more frequent all over the world. However, it is unclear how important the topic of allergies is for the general German population and how appropriately patients with allergies are treated.

Drug supply for psoriasis - results from a national pharmacy network.

In Germany, drugs are to a large extent provided by pharmacies. Thus, investigations in pharmacies permit drug usage studies both on patients receiving prescribable drugs and using self‐medication. The current study evaluated the quality of medical care, disease burden and spectrum of treatments for patients with psoriasis in a nationwide network of pharmacies.

Internet-supported gathering of treatment data and patient benefits in psoriasis

Background  Studies about health care of psoriasis patients in Germany are predominantly carried out in dermatological centres, which results in a certain selection bias. To collect data from other sources of patients, the German Centre of Health Services Research in Dermatology conducted a series of web‐based studies. The extent of how data on health care on psoriasis gathered online vary from paper and pencil data is yet to be explored.

Allergien in Deutschland – Häufigkeit und Wahrnehmung in der Bevölkerung

Zusammenfassung Hintergrund: Die Prävalenz allergischer Erkrankungen hat in den letzten Jahrzehnten weltweit zugenommen. Unklar war bisher, wie die Thematik allergischer Erkrankungen in der Bevölkerung wahrgenommen wird und wie allergische Erkrankungen in der deutschen Bevölkerung versorgt werden. Patienten und Methodik: In einer repräsentativen Stichprobe der erwachsenen deutschen Bevölkerung von n = 1 004 Personen wurde durch das Institut Forsa (Forsa Gesellschaft für Sozialforschung und statistische Analysen mbH) vom 31.01. bis 02.02.2012 eine strukturierte Telefonbefragung durchgeführt. Ergebnisse: 52 Prozent der Befragten hielt Allergien für ein persönlich wichtiges Thema, bei 33 % wurde durch einen Arzt eine Allergie festgestellt. Die Allergierate war bei höheren Bildungsgraden höher, unterschied sich aber nicht zwischen Ostund Westdeutschland. Unter den Allergikern gaben 53 % an, durch ihre Allergie belastet zu sein, 48 % litten unter Leistungseinbußen wegen allergischer Symptome. Unter den Pollenallergikern wurde bei 28 % eine spezifische Immuntherapie durchgeführt, mit der 70 % zufrieden waren. Während 58 % eine Selbstmedikation angaben, wurden nur 21 % im Zuge ihrer allergischen Schübe ärztlich mit Medikamenten behandelt. Schlussfolgerungen: Allergien sind in der deutschen Bevölkerung häufig, oftmals belastend und werden dennoch nicht regelhaft ärztlich und medikamentös versorgt. Der Anteil an Patienten mit spezifischer Immuntherapie als Kausaltherapie ist vergleichsweise niedrig. Aktive Maßnahmen zur Verbesserung der Inanspruchnahme des allergologischen Spezialisten sind in Deutschland notwendig.

Measurement of healthcare quality in atopic dermatitis - development and application of a set of quality indicators

Quality indicators are essential tools for the assessment of health care, in particular for guideline‐based procedures.

Contents Vol. 228, 2014

G. Argenziano, Reggio Emilia M. Augustin, Hamburg W.H. Boehncke, Geneva L. Borradori, Bern R.P. Braun, Zürich R. Cerio, London L. Cerroni, Graz O. Chosidow, Créteil A. Dupuy, Rennes J.W. Fluhr, Berlin L. French, Zürich F. Furukawa, Wakayama M. Gilliet, Lausanne A.K. Gupta, London, Ont. R. Happle, Freiburg R.J. Hay, London P. Itin, Basel G. Kaya, Geneva R.G.B. Langley, Halifax, N.S. J.M. Mascaro, Jr., Barcelona K. Matsunaga, Nagoya Y. Miyachi, Kyoto L. Naldi, Bergamo F. Nestle, London C. Paul, Toulouse T. Shiohara, Tokyo Th. Simonart, Brussels H.P. Soyer, Brisbane, Qld. L. Thomas, Lyon R.M. Trüeb, Zürich T.J. Yoon, Jinju Ch.C. Zouboulis, Dessau International Advisory Board