Research Article

Pharmacist-patient interaction and medication history

interview on psoriasis patients
Mohamed Zerein Fathima1, T. S. Shanmugarajan1, Shaik Vaheeda Rehman2*

ABSTRACT

Aim: Psoriasis is a common, chronic skin disease labeling from both the community and individuals due to its effects on
appearance. Objectives: The main objective of this study is to describe and explain the percentage of the people affected with
psoriasis. The present research is a study of patients aimed to evaluate the pharmacist-patient interactions and medication
history interview on psoriasis at Limat Multispeciality Hospital, Padur, Chennai. Methods: A  total of 100  patients were
selected randomly and were interviewed for the psoriasis, in two sessions (morning and evening). Results: After the interview,
it was seen that most of the people affected were from semi-urban areas who are earning 1000–3000 mid-aged persons and
mostly married male persons are affected with the disease. In most of the people, the detection of the disease is between
1 and 5 years of time period, according to the affected people survey, most of the people were affected on their body with
moderate severity. For the psoriasis, the treatment can be through topical, UVB, and oral; nowadays, the treatment mostly
used is topical. Conclusion: All the patients are needed a further awareness on the psoriasis and need advanced treatment.

KEY WORDS: Psoriasis, Patient interaction, Treatment

INTRODUCTION (dermis), which contains the nerves and blood and

Psoriasis is a chronic skin disorder marked by periodic
flare-ups of sharply defined red patches, covered by
a silvery, flakey surface. The main disease activity
leading to psoriasis occurs in the epidermis, the top
five layers of the skin.[1] The process starts in the basal
(bottom) layer of the epidermis, where keratinocytes
are made. Keratinocytes are immature skin cells
that produce keratin, a tough protein that helps to
form hair,[2] nails, and skin. In normal cell growth,
keratinocytes grow and move from the bottom layer
to the skin surface and shed unnoticed. This process
takes about a month. In persons with psoriasis, the
keratinocytes multiply very rapidly and travel from the
basal layer to the surface in about 4 days.[3] The skin
cannot shut these cells quickly enough, so they build
up, leading to thick, dry patches or plaques. Silvery,
flaky areas of dead skin build up on the surface of the
plaques before being shed. The underlining skin layer
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lymphatic vessels, becomes red and swollen.[4]
DIAGNOSIS OF PSORIASIS
A  microscopic examination of the tissue taken from
the affected skin patch is needed to make a definitive
diagnosis of psoriasis and to distinguish it from other
skin disorders.[5] Usually in psoriasis, the examination
will show a large number of dry skin cells but without
many signs of inflammation or infection. Specific
changes in the nails are often strong of psoriasis.
Severity of Disease
Severity of psoriasis itself ranges from one or two flaky
inflamed patches to widespread pustular psoriasis
that, in rare cases, can be life threatening.[6] To help
determined the best treatment for a patient, doctors
usually classify the disease as mild to severe.[7] The
classification depends on how much of the skin is
affected. Mild psoriasis affects <3% of the body
surface.[8] Most cases of psoriasis are limited to <2%
of the skin. Moderate psoriasis covers 3–10% of the
skin. If more than 10% of the body is affected, the

1
Department of Pharmaceutics, School of Pharmaceutical Sciences, Vels Institute of Science, Technology and Advanced
Studies, Pallavaram, Chennai, Tamil Nadu, India, 2Department of Pharmacology, School of Pharmaceutical Sciences, Vels
Institute of Science, Technology and Advanced Studies, Pallavaram, Chennai, Tamil Nadu, India

*Corresponding author: Shaik Vaheeda Rehman, Department of Pharmacology, School of Pharmaceutical Sciences, Vels
Institute of Science, Technology and Advanced Studies Velan Nagar, P.V.Vaithiyalingam Road, Pallavaram, Chennai – 600 117,
Tamil Nadu, India. Phone: +91-9581958460. E-mail:vaheeda.rehmans@gmail.com

Received on: 27-09-2017; Revised on: 24-10-2017; Accepted on: 29-01-2018

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 Mohamed Zerein Fathima, et al.

disease is considered severe. The palm of the hand children who are younger than 10 years. According to
equals 1% of the body.[9] The severity of the disease a study in India, 60% of the patients had the disease
is also measured by its effect on a person’s quality onset before the age of 30 years, with a positive family
of life. However, the National Psoriasis Foundation history in almost 14% of the cases. Skin and scalp was
has proposed a new classification method.[10] The the most commonly affected site. The inheritance of
group suggests a new two-tiered system that classifies psoriasis does not fit into the Mendelian pattern. When
patients as needing either local or body-wide (systemic) one parent has the disease the chances of the child to
treatment.[11] While disease severity impacts treatment develop the disease are 15–20%, if both the parents
success, some forms of psoriasis can be very resistant have the disease, the chances of the child getting the
to treatment even though they are not categorized as disease are 50%. One of the longest known illness,
severe.[12] They include: psoriasis is also one of the most misunderstood, as it
was often confused with leprosy.
• Any psoriasis on the palms and soles (hand and foot
psoriasis). METHODOLOGY
• Inverse psoriasis (which occurs in the folds of the
skin). Site Selection for Study
• Scalp psoriasis. The study was conducted in a private hospital in Limat
• Psoriatic arthritis. Multispeciality Hospital, Padur, Chennai. The hospital
is unique and well known for its general treatment and
Aim and methodology
other services for the people who come from various
The study was aimed to evaluate pharmacist-patient
interaction and medication history interview on Table 6: Categorization of patients based on finance
psoriasis patients. Every year 150,000 and 260,000 Particulars Number of patients (%)
new cases are diagnosed, and this includes 20,000 in Below 1000 27 (27)
1000–3000 42 (42)
3000–5000 17 (17)
Table 1: Categorization of patients based on age Above 5000 14 (14)
Particulars Number of patients (%)
Table 7: Categorization of patients based on when
10–20 15 (15) diagnosed
21–30 12 (12)
31–40 31 (31) Particulars (years) Number of patients (%)
41–50 16 (16)
51–60 15 (15) <1 26 (26)
61–70 11 (11) 1–5 47 (47)
6–10 27 (27)
Table 2: Categorization of patients based on marital
status Table 8: Categorization of patients based on body part

Particulars Number of patients (%) Particulars Number of patients (%)

Married 52 (52) Face 7 (7)
Single 48 (48) Scalp 13 (13)
Arm 12 (12)
Leg 8 (8)
Table 3: Categorization of patients based on sex Hand 6 (6)
Foot 12 (12)
Particulars Number of patients (%) Body 38 (38)
Male 57 (57) Nail 4 (4)
Female 43 (43)
Table 9: Categorization of patients based on types of
Table 4: Categorization of patients based on area of treatments
living
Particulars Number of patients (%)
Particulars Number of patients (%)
Topical 50 (50)
Urban 14 (14) UVB 10 (10)
Semi‑urban 58 (58) Oral 30 (30)
Rural 28 (28) Alternative medicine 10 (10)
UVB: Ultraviolet‑B
Table 5: Categorization of patients based on education
Table 10: Categorization of patients based on severity
Particulars Number of patients (%)
10th 14 (14) Particulars Number of patients (%)
+2 24 (24) Mild 24 (24)
UG 42 (42) Moderate 56 (56)
PG 20 (20) Severe 20 (20)

Drug Invention Today | Vol 10 • Issue 3 • 2018 417

 Mohamed Zerein Fathima, et al.

Figure 1: Illustration of the categorization of patients based

on age Figure 5: Illustration of the categorization of patients based
on education

Figure 2: Illustration of the categorization of patients based

on marital status Figure 6: Illustration of the categorization of patients based
on finance

Figure 3: Illustration of the categorization of patients based

on sex
Figure 7: Illustration of the categorization of patients based
on when diagnosed

Figure 4: Illustration of the categorization of patients based Figure 8: Illustration of the categorization of patients based
on area of living on body parts

parts of Chennai. The hospital is well equipped with The study was conducted in the department of general
diagnosis facility hi-tech operation theater. and other services. Interview was conducted for a
period of 3  months in March, April, and May 2009.
Department Selected All details regarding the patients and their medication

418 Drug Invention Today | Vol 10 • Issue 3 • 2018

 Mohamed Zerein Fathima, et al.
Figure 9: Illustration of the categorization of patients based
on treatment
Figure 10: Illustration of the categorization of patients
based on severity
history were taken and recorded in a standard data
entry form. The interview was done in morning and
evening section.
Structure of Interview
Structure of patient interview is readily up to the
individual interviewer. The interview was conducted
in two sessions by the pharmacy undergraduates
confidentially. There was numerous forms we were
used for this study. The form contains the patient
details like Patient name, general information, IP/OP
number, address, age, sex, patient past drug history.
All details were collected carefully. And entered into
that form.
Preparation of Interview Report
In the present work, the interview was made among
100  patients. The interview was conducted in two
sessions (morning and evening). Each interviewer
interviewed at least one patient a day. At the end of the
period of interview, consolidated report was prepared
and consolidated report was expressed in terms of
Figures 1-10 and Tables 1-10. A complete information
has been elected regarding the patient medication
history, present medication, physiological change in
body, etc., in some patients, some questions may be
asked more than once or same question asked in a
different manner before and acceptable answer was
obtained.
Drug Invention Today | Vol 10 • Issue 3 • 2018
RESULTS AND DISCUSSION
The study on psoriasis patients was conducted in a
hospital in Limat Multispeciality Hospital, Padur,
Chennai. A  prospective observation and patient
interview was done in selected in patients/outpatients,
admitted for treatment over a period of 3  months
in 2009. During this period, 100  patients were
interviewed. Depending on the age, most cases were
in the range of 31–40 years (31%), followed by the age
41–50 years (16%), 10–20 years (15%), 51–60 years
(15%), 21–30  years (12%), and 61–70  years (11%).
Based on marital status, 52% of patients were married
and remain 48% were single. Based on sex, 57%
patients were male and 43% patients were female.
Depending on area living, 58% were from semi-urban,
28% were from rural, and 14% were from urban.
Depending on the education, undergraduate was most
affected 42% followed by 24%, postgraduate 20%,
and matriculation or below 14%. Based on monthly
income, patients with monthly income between
1000 and 3000 were more affected 42% followed by
monthly income below 1000 (27%) between 3000 and
5000  (17%) and above 5000  (14%). Based on when
the disease was diagnosed, <1 year (26%), 1–5 years
(47%), and 6–10  years (27%). In this study, 38% of
patients were effected on all body followed by scalp
(13%), on foot (12%), on arm (12%), on leg (8%),
on face (7%), on hand (6%), and on nail (4%). Based
on type of treatment taken, most of the patients taken
treatment topically (50%), 30% of patients taken
oral treatment, and 10% of patients taken UVB and
alternative treatment. Depending on the severity
of disease, 50% of patients found to be moderate,
remaining 26% patients were severe in condition and
24% were mildly affected.
CONCLUSION
Based on the results of the patients with psoriasis, they
need further advanced treatment those who are living
in semi-urban and mid-aged people. They need an
awareness program of the psoriasis, cause of psoriasis
and affect and the preventions for psoriasis.
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Source of support: Nil; Conflict of interest: None Declared
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