JOURNAL READING

Treatment and Referral Patterns for

Psoriasis in United Kingdom Primary
Care: a Retrospective Cohort Study
Javaria Mona Khalid, Gary Globe, Kathleen M Fox, Dina Chau, Andrew Maguire and Chio-
Fang Chiou

Disusun Oleh:
M. Irfan Permana H (2008730082)

Pembimbing :
dr. Bowo Wahyudi, Sp.KK

KEPANITERAAN KLINIK STASE KULIT

RUMAH SAKIT UMUM KOTA BANJAR
FAKULTAS KEDOKTERAN UNIVERSITAS MUHAMMADIYAH JAKARTA
PERIODE 05 FEBRUARI – 11 MARET 2018
 BACKGROUND
PSORIASIS

a serious chronic inflammatory skin disease

with varying degrees of severity and disability

Prevalence of psoriasis has been reported to be

between 0.24% - 1.5%,
causes physical impairment, pain, and
psychological stress, including impairment in
social settings and workplace, and poor health-
related quality of life
National Institute for Health and Clinical Excellence (NICE)
and the British Association of Dermatologist (BAD)

Mild - Moderate Greater Psoriasis

•phototherapy, systemic
topical drugs: drugs (methotrexate,
corticosteroids, coal ciclosporin, acitretin, and
tar, dithranol, hydroxycarbamide).
retinoids, and vitamin •Anti-tumor necrosis
D3 analogues factor agents
 METHODS

• 1 July 2007-31 October 2009

Time of
Research

• Comprised of patients in THIN with a diagnosis of psoriasis and

Study were managed by their general practitioner
Population

• Incidence of psoriasis, the proportion characteristics and treatment

Study patterns of patients referred to dermatologist
Measures

• Refferal rates: Kaplan-Meier survival method

• Conditional logistic regression to calculate OR
Statistical • Multivariate: adjusted age, gender and variable that significantly
Analysis different
RESULT
 34/10,000
person-
years

•The incidence rate : 28 (95% CI: 28–29) per 10,000

person-years
•referral rate: 18.1 (95% CI: 17.3-18.9) per 100
person-years.
•61% of referred patients were referred to a
dermatologist within 30 days of diagnosis
(immediately referred) and 39% were referred
after 30 days post-diagnosis
DISCUSSION
 28 patients per
Previous population: 10,000 person-years
14 per 10,000 were newly
person-years diagnosed with
psoriasis in the UK

1. Previous studies were conducted prior to the

introduction of the Quality Outcomes Framework
(QOF) guidelines
2. An increased awareness of psoriasis and new
treatment options
 the previously
reported figure of
18% of patients were
0.7% in 2003 using
referred
data from the Doctor’s
Information Network

The present study: the recent availability

(since 2003) of biologics in secondary care
and biologics can only be prescribed by a
specialist in the UK.
 Most patients were referred immediately
after the psoriasis diagnosis

• These patients may present with severe psoriasis at the time of

diagnosis.
 Vitamin D3
analogues, Refferal to a
Corticosteroid, dermatologist
tar product

GPs are
following
the UK
NICE and
BAD
guidelines
 CONCLUSION
The current estimates of the diagnosed psoriasis population and
referral rates to dermatologists may assist in understanding the
burden on the UK healthcare system