title: Psoriasis and cardiovascular screening rates in the United States.
abstract: BACKGROUND
  Guidelines to screen for cardiovascular (CV) risk factors in psoriasis patients have been established. However, the frequency with which dermatologists and nondermatologists screen psoriasis patients for CV risk factors is not well characterized.
  
  
  OBJECTIVE
  To determine how frequently psoriasis patients are screened for CV risk factors in the ambulatory care setting and to identify factors affecting screening rates.
  
  
  METHODS
  Data from the 2005 to 2009 National Ambulatory Medical Care Survey (NAMCS) were analyzed to determine screening rates for blood pressure, glucose, cholesterol, and body mass index (BMI). The probability of a patient having at least 1 of the 4 risk factors screened was determined and was termed the "composite" score. Screening rates were assessed by physician specialty, patient demographics, and clinical practice characteristics.
  
  
  RESULTS
  There were an estimated 11.4 million psoriasis patient visits from 2005 to 2009. Blood pressure, glucose, cholesterol, and BMI were evaluated at 32.2%, 5.9%, 9%, and 26% of psoriasis visits, respectively, with a composite score of 41.2%. Patients without psoriasis were screened for these CV risk factors at 59.0%, 6%, 8%, and 38.1% of outpatient visits, respectively, with a composite score of 66.3%. The results of a multivariate analysis accounting for patient age differences indicated psoriasis had a statistically significant effect on rates of blood pressure and BMI screening. In general, screening rates were higher if the patient was male, African American, or non-Hispanic, and screening rates were relatively equal across age groups. Higher screening rates were also associated with primary care specialties, faculty practice or community health clinics with contracted physicians, clinics that utilized electronic medical records, practices with a higher percentage of revenue from a Medicare/Medicaid payer, or offices with discounted fees and capitation payment structures.
  
  
  CONCLUSIONS
  Data from NAMCS are cross-sectional, permitting assessment of screening rates based on visits but not on patients.
  
  
  CONCLUSIONS
  Screening for high blood pressure, diabetes, hypercholesterolemia, and obesity are not performed at most outpatient visits for psoriasis. Care should be taken to ensure that patients do receive appropriate screening for the comorbidities associated with psoriasis.
authors: Department of Dermatology, Center for Dermatology Research, Wake Forest School of Medicine, Winston-Salem, NC, USA.
authors: Habibollah S
authors: HS
authors: Alamdari
authors: Cheryl J
authors: CJ
authors: Gustafson
authors: Scott A
authors: SA
authors: Davis
authors: William
authors: W
authors: Huang
authors: Steven R
authors: SR
authors: Feldman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000150:complications / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003627:Data Interpretation, Statistical; D003880:Dermatology; D003920:Diabetes Mellitus / Q000175:diagnosis; D005006:Ethnicity; D005260:Female; D017408:Guidelines as Topic; D019538:Health Care Surveys; D006630:Hispanic or Latino; D006801:Humans; D006937:Hypercholesterolemia / Q000175:diagnosis; D006973:Hypertension / Q000175:diagnosis; D007223:Infant; D038801:International Classification of Diseases; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000175:diagnosis; D010820:Physicians; D011565:Psoriasis / Q000150:complications / Q000175:diagnosis*; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult