title: The burden of psoriasis and barriers to satisfactory care: results from a Canadian patient survey.
abstract: BACKGROUND
  The physical, mental, social, and financial burdens experienced by Canadians with psoriasis are relatively unexplored.
  
  
  OBJECTIVE
  To gain an understanding of the impact of psoriasis on Canadians.
  
  
  METHODS
  An online survey, "Stand Up and Speak Out," was provided to Psoriasis Education Program users who had given consent to be contacted.
  
  
  RESULTS
  Ninety-five percent of respondents had moderate to severe psoriasis, a high proportion relative to similar studies. Respondents reported medical and psychological comorbidities, with prevalence up to fourfold higher than Canadian background rates. Respondents also reported reduced income and increased unemployment, at levels that increased with psoriasis severity. Use of biologics was associated with high levels of satisfaction relative to other treatment options. However, biologic use was not uniform but was strongly correlated with insured status and annual income.
  
  
  CONCLUSIONS
  In this severely affected population of Canadians with psoriasis, the physical, mental, social, and financial burden of disease was high.
authors.affiliation: Dermatology Department, Northern Ontario School of Medicine, Lakehead University, Thunder Bay, ON, Canada.
authors.forename: Ronald
authors.initials: R
authors.lastname: Mahler
authors.forename: Christine
authors.initials: C
authors.lastname: Jackson
authors.forename: Horia
authors.initials: H
authors.lastname: Ijacu
mesh_terms: D000293:Adolescent; D000328:Adult; D002170:Canada / Q000453:epidemiology; D016009:Chi-Square Distribution; D015897:Comorbidity; D005260:Female; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D020407:Internet; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D015995:Prevalence; D011565:Psoriasis / Q000191:economics / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014478:Unemployment / Q000706:statistics & numerical data