%0 Journal Article
%T Treatment of patients with psoriasis: assessment of daily attitudes and habits of physicians working on dermatological wards Post powanie z chorymi na  uszczyc : ocena postaw i zachowa¨˝ lekarzy oddzia ¨®w dermatologicznych w codziennej praktyce lekarskiej
%A Adam Reich
%A Jacek Szepietowski
%J Clinical Dermatology
%D 2011
%I 
%X Introduction: Psoriasis is not only connected with the presence of skin lesions or joint problems, but may increase the risk of diabetes, disease of circulation or obesity. More efficacious and safer systemic therapies improve treatment results of psoriasis, and possibly also reduce the risk of comorbidities. However, the access to novel treatment modalities also create a need of applying uniform criteria which will entitle patients to receive this kind of treatment as well as defining treatment goals. Objective: The aim of the study was to evaluate the standard of care on psoriatic patients among Polish dermatologists during routine daily practice. Material and methods: A total of 99 physicians (61 specialists and 38 residents) were included into the study. All participants were asked to complete a specially designed questionnaire about the health-care among patients with psoriasis. Results: The majority of participants (79.8%) declared, that the assessment of psoriasis severity has been done at each patient visit. Disease severity was most commonly evaluated with PASI (83.8%) or based on the self-assessment of psoriasis severity (54.5%). Uncommonly, the subjective perceiving of disease influence on a patient (21.2%) was measured. The antipsoriatic therapy was most commonly (42.4%) modified due to its ineffectiveness as soon as 4-6 weeks after treatment initiation, less commonly (24.2%) after 8-12 weeks. Methotrexate (96.0%), cyclosporin (89.9%) and PUVA (87.9%) were the most commonly used conventional systemic treatments, while etanercept (62.6%), infliximab (46.5%) and adalimumab (35.4%) were most frequently used among biologicals. Patients qualified to biological therapy underwent more detailed laboratory examinations compared to those who were prepared to conventional systemic treatment. Based on the physicians' opinions, the most bothersome aspects of psoriasis was the presence of psoriatic lesions on visible body areas (58.6%), followed by pain (40.4%), chronic and recurrent course of the disease (31.3%), the necessity of the long-term treatment (28.3%), pruritus (25.3%) and lack of acceptance in families and among friends (24.2%). Conclusions: Based on this questionnaire study it was revealed, that no standardized diagnostic and therapeutic algorithm exists in Poland for patients with psoriasis. Implementation of evidence-based diagnostic and therapeutic recommendations should be promoted in the future to improve the standard of health care and patients' satisfaction from treatment.
%K uszczyca
%K wytyczne
%K ci  ko   choroby
%K standard opieki zdrowotnej
%K 
%U http://cornetis.pl/pliki/DK/2011/2/DK_2011_2_57.pdf