A PROSPECTIVE STUDY OF DRUG UTILIZATION AND QUALITY OF LIFE IN PSORIASIS PATIENTS IN DERMATOLOGY DEPARTMENT OF A TERTIARY CARE TEACHING HOSPITAL

Purpose/aim: To assess the current prescription pattern, efficacy, tolerability and impact on Quality of life(QoL) in psoriasis patients. Material: An observational, prospective study of 18 months was carried out in a tertiary care teaching hospital. Newly diagnosed patients of psoriasis, aged ≥ 18 years were included in the study. The demographic, clinical profile, psoriasis area severity index (PASI) and drug utilization were recorded. Follow up was done at 15 days interval for two and a half months. Patient’s QoL was assessed using Psoriasis Disability Index (PDI). Results: A total 100 patients were enrolled in the study. At the time of diagnosis, 43 patients had PASI score ≤10 and 57 had > 10. At the last follow up 96 patients had PASI sore ≤ 10 and 4 had > 10. Mean of QoL at the time of diagnosis was 10.43 and at the last follow up 6.1. Pre and post-treatment PASI score showed direct intermediate significant correlation with pre and post-treatment QoL score. Most frequently fixed drug combination(FDC)of steroid and keratolytic agent were prescribed followed by anti-histaminics, steroids, minerals, anti-microbial agents, emollients, vitamins, H2-blockers, immunosuppressants, and NSAIDS.WHO core indicators were used to analyse drugs prescribed. Conclusions: In this study, the treatment of psoriasis is according to the “NICE” guideline. Patient’s treatment adherence increased because of the QoL improvement. Thus, the QoL tools are important measure of patient satisfaction and treatment monitoring. Keywords: Psoriasis area severity index, Psoriasis Disability Index, Quality of life, Drug Utilization in Psoriasis

Evaluation of ustekinumab treatment in psoriasis and the potential effect of metabolic syndrome on treatment response: a single center retrospective study

<p class="abstract"><strong>Background:</strong> Ustekinumab is a biological agent used in the treatment of psoriasis. This study evaluated the treatment response of psoriasis patients who received ustekinumab.</p><p class="abstract"><strong>Methods:</strong> The study included nine patients with plaque-type psoriasis who received ustekinumab treatment. Clinical response of all patients was evaluated with psoriasis area and severity index (PASI), dermatology life quality index (DLQI), and psoriasis disability index (PDI) at 0, 4, 16 and 28 weeks. The patients were also evaluated for metabolic syndrome and its effect on treatment response.<strong></strong></p><p class="abstract"><strong>Results:</strong> A total of five male and four female patients with psoriasis vulgaris were included in the study. At the end of 28th weeks, 55% of the patients reached PASI 75 score. The mean PASI scores of the patients at weeks 0, 4, 16, 26 and 28 were 36.98±12.28, 8.86±9.06, 9.52±11.55, 3.55±3.61 and 6.98±6.40, respectively. Although not statistically significant, at the 28th weeks, the mean PASI, DLQI and PDI values of the patients with metabolic syndrome were higher than those without metabolic syndrome (p=0.505, p=0.314, p=0.786, respectively).</p><p class="abstract"><strong>Conclusions:</strong> Ustekinumab is an effective treatment option for patients with psoriasis who resistant to conventional and biological treatments. In resistant cases to the ustekinumab, the routine treatment interval should be reduced. Psoriasis patients with accompanying metabolic syndrome may have a lower response rate than those without metabolic syndrome to biological agents.</p>

Quality of life issue in psoriasis: A study from western Nepal

Background: Psoriasis may have negative impact on a patient’s quality of life. Very few studies have examined this aspect in Nepalese population. Aim of this study was to evaluate the Quality of life (QOL) in chronic psoriatic patients by modified version of psoriasis disability index (PDI).Methods: Present cross sectional study was conducted in three major hospitals in western Nepal. One hundred chronic psoriatic patients of 18 years or more of age, with disease duration of six months or more and body surface area involvement of 10% or more were recruited. Clinical assessment was done with psoriasis area severity index (PASI) and quality of life was measured by modified version of PDI. Patients were managed as per indication. At the follow up at four weeks, improvement in PASI and improvement in QOL was measured. Statistical analysis by Chisquare test was done to assess the relation between severity of psoriasis and different items of quality of life.Results: Psoriasis has negative impact on all aspect of quality of life in Nepalese patients, as shown by score of modified version of PDI, which was 39.27% of total. There was significant improvement in PASI at follow up visit, from 23.29% to 15.35% of total. There was significant improvement in quality of life after treatment (modified version of PDI) from 39.27% to 32.66% of total.Conclusions: Psoriasis has negative impact on all aspect of quality of life in Nepalese patients.Nepal Journal of Medical Sciences Vol.3(2) 2014: 116-120