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The patient’s perspective

Management of psoriasis in an ideal world: the patient’s perspective

Best practice for psoriasis management sees interested and enthusiastic healthcare professionals working with their patients in order to set realistic targets for treating psoriasis

Helen McAteer Chief Executive The Psoriasis Association

Around one-third of people with psoriasis first experience the condition before the age of 16 years1

and, while there

are a number of treatments available, it is an unwanted companion for life for many. People with psoriasis often report feeling lonely and isolated, having to cope with the condition on their own. However, due to the peak onsets of the condition (16 years and 60 years for females, and 22 years and 57 years for males2

), the impact

of living with psoriasis affects more people than the individual concerned, for example, parents, siblings and spouses. In a study looking into the effects living with a person with a skin condition can have on one’s life, Basra and Finlay observed that 98% of spouses and parents reported a psychological impact including worry, depression, anxiety and embarrassment.3 In the same study, 54% of participants felt that looking after the patient took a great deal of their time, highlighting the responsibility of applying treatments. Other areas of frustration included an increase in housework (42%) such as frequent vacuuming and laundry, and this then impacted on holidays (46%). Basra and Finlay noted that some people had stopped going on holiday altogether, while others had to give special consideration when planning a holiday. Members of the

“When patients feel that their healthcare provider is interested in them and their condition, then they in turn feel valued, supported and enthused by the treatments on offer”

People with psoriasis report that it has affected their educational performance (31%), and negatively affected their working life (59%)4

of a condition often thought to simply affect the skin run much deeper. The timing of early onset psoriasis coincides with the period of life where romantic relationships are often formed and a 2009 web-based survey of 1760 patients with psoriasis4

found 72% of

respondents felt that psoriasis made them feel uncomfortable about dating and 60%

– therefore the effects

Too often patients with psoriasis are greeted with a disheartened “Oh, you’ve got psoriasis”. If patients are greeted with an uplifting and interested “Oh, you’ve got psoriasis!”, the patient’s experience of this life-long, often life-ruining condition could be very different. When patients feel that their healthcare provider is interested in them and their condition, then they in turn feel valued, supported and enthused by the treatments on offer. The involvement of the healthcare provider in correctly diagnosing psoriasis

Psoriasis Association report taking handheld vacuum cleaners on holiday, or restricting themselves to self catering to avoid embarrassment of excess skin scales and blood on bedding. The recognition of the impact on family members of people with skin conditions has led to the phrase ‘the Greater Patient’.

Patients do not take for granted the role of a loved one in their care; 66% report that they would find it difficult to cope with their psoriasis without the support of their partner/family,4

and so it is

important to take into consideration the impact of the condition on others.

said that it had prevented them from pursuing an intimate relationship. Of those who had settled in a relationship, 24% said that their psoriasis had caused an intimate relationship to end – again highlighting the impact of this condition on the greater patient.4

Healthcare provider involvement in diagnosis, prescribing and referrals At the Primary Care and Public Health Conference 2013, Dr Steven Kownacki, a GP with a Special Interest in Dermatology, explained the importance of an “Oh” when GPs greet patients with a skin condition.


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