title: Trends in older adult psoriasis outpatient health care practices in the United States.
abstract: BACKGROUND
  Psoriasis is among the top dermatologic diagnoses for older adult patients, and the number of older adult psoriasis patients is expected to rise.
  
  
  OBJECTIVE
  To characterize trends in older adult psoriasis health care practices of US ambulatory physician offices from 1993 to 2009.
  
  
  METHODS
  We used data from the National Ambulatory Medical Care Survey to assess demographics, specialties seen, and treatment in visits by older adult patients, 55 years of age and older.
  
  
  RESULTS
  There were approximately 14.1 million outpatient visits for psoriasis among the older adult population during the study period. Older adult psoriasis patients were 52.4% female and 47.6% male. The most frequent older adult age group seen for psoriasis was the 55 to 64 year age group. Dermatologists saw 69.3% of patients, internists saw 14.5%, and general and family practitioners saw 11.6%. Topical corticosteroids were the most frequently prescribed medications. Dermatologists preferred clobetasol whereas non-dermatologists more commonly prescribed betamethasone. For both the 18 to 54 year age group and the 55 and older group, the leading 7 out of 10 medications prescribed were topical corticosteroids and calcipotriene. However, etanercept, coal tar, and fluocinolone were among the leading medications in the younger group but not in the 55 and older group.
  
  
  CONCLUSIONS
  Treatment approach for older adult psoriasis patients showed some differences among medical specialties and among the younger and older age groups. Further research specific to older adult psoriasis patients is needed to determine optimal treatment strategies for this patient population.
authors.affiliation: University of Utah School of Medicine, Salt Lake City, UT, USA. jillianwwong@gmail.com
authors.forename: Jillian W
authors.initials: JW
authors.lastname: Wong
authors.forename: Scott A
authors.initials: SA
authors.lastname: Davis
authors.forename: Steven R
authors.initials: SR
authors.lastname: Feldman
authors.forename: John Y M
authors.initials: JY
authors.lastname: Koo
mesh_terms: D000279:Administration, Cutaneous; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000639:trends*; D001623:Betamethasone / Q000627:therapeutic use; D002117:Calcitriol / Q000031:analogs & derivatives / Q000627:therapeutic use; D002990:Clobetasol / Q000627:therapeutic use; D003033:Coal Tar / Q000627:therapeutic use; D003879:Dermatologic Agents / Q000627:therapeutic use; D003880:Dermatology / Q000706:statistics & numerical data; D000068800:Etanercept; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D005446:Fluocinolone Acetonide / Q000031:analogs & derivatives / Q000627:therapeutic use; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D019538:Health Care Surveys; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use; D007155:Immunologic Factors / Q000627:therapeutic use; D007388:Internal Medicine / Q000706:statistics & numerical data; D007641:Keratolytic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000639:trends*; D011565:Psoriasis / Q000188:drug therapy*; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D014481:United States; D055815:Young Adult
chemical_list: D003879:Dermatologic Agents; D005938:Glucocorticoids; D007074:Immunoglobulin G; D007155:Immunologic Factors; D007641:Keratolytic Agents; D018124:Receptors, Tumor Necrosis Factor; D005446:Fluocinolone Acetonide; C055085:calcipotriene; D003033:Coal Tar; D001623:Betamethasone; D002990:Clobetasol; C035394:fluocinolone; D002117:Calcitriol; D000068800:Etanercept