title: Attitude to treatment of patients with psoriasis attending spa center.
abstract: OBJECTIVE
  The aim of this paper was to investigate beliefs and preferences towards treatment of patients with psoriasis attending Comano SPA (Trentino, Italy) in comparison to patients referring to the University Hospital of Verona.
  
  
  METHODS
  Patient with psoriasis referring to Comano SPA and to the University Hospital of Verona were visited, their clinical data were collected and they were administered a questionnaire investigating their knowledge about psoriasis, as well as their attitude and preferences towards conventional therapies and SPA treatments.
  
  
  RESULTS
  [Corrected] A total of 288 patients with chronic plaque psoriasis were recruited, 169 from Comano SPA and 119 from Verona Hospital. There were no differences regarding demographic data, severity of psoriasis, impact on quality of life and prevalence of cardio-metabolic comorbidities between the two groups. SPA patients more rarely believed that pharmacological treatments are safe and effective (6.5% vs. 21.8% P=0.001), had less trust in physician (32.5% vs. 67.2%; P=0.001) and preferred alternative therapies like balneotherapy compared to hospital patients (55.6% vs. 30.3%; P=0.0001), because they assumed they were more safe and effective than systemic drugs (37.3% vs. 1.7%; P=0.001). SPA patients preferred living with psoriasis rather than taking drugs to treat it more commonly than hospital patients (26.6% vs. 5%; P=0.001).
  
  
  CONCLUSIONS
  Patients attending a SPA centre tend to trust conventional drug treatments less often than those attending a hospital clinic, and prefer balneotherapy as a dedicated alternative therapy. Fear of adverse events is a major concern among patients with psoriasis, especially those attending a SPA center.
authors.affiliation: Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy. paolo.gisondi@univr.it
authors.forename: P
authors.initials: P
authors.lastname: Gisondi
authors.forename: S
authors.initials: S
authors.lastname: Farina
authors.forename: M V
authors.initials: MV
authors.lastname: Giordano
authors.forename: M
authors.initials: M
authors.lastname: Zanoni
authors.forename: G
authors.initials: G
authors.lastname: Girolomoni
mesh_terms: D001294:Attitude to Health; D001452:Balneology; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000628:therapy*; D011795:Surveys and Questionnaires