title: Limited evidence of the effects of patient education and self-management interventions in psoriasis patients: a systematic review.
abstract: OBJECTIVE
  To describe the contents of educational and self-management programmes for patients with psoriasis, and to evaluate their effects.
  
  
  METHODS
  A systematic review of randomized controlled trials (RCTs), quasi-randomized trials and controlled clinical trials identified by a systematic literature search. Risk of bias was assessed by two independent reviewers and interventional effects were summarized descriptively and by meta-analysis.
  
  
  RESULTS
  Nine studies were included, which ranged from single brief interventions to long complex multidisciplinary programmes. Four RCTs with adequate sequence allocation were included to analyze interventional effects. One RCT compared two different educational programmes and found no differences between groups. The results of three trials that focused on combinations of education and self-management were heterogeneous. One RCT based on a 12-week comprehensive programme reported statistically significant effects (p<0.05) on disease severity and health-related quality of life. Two RCTs with less comprehensive programmes reported no effects on HRQoL.
  
  
  CONCLUSIONS
  This review showed that little evidence is available to support the effects of educational and self-management interventions in patients with psoriasis that are studied in RCTs. There is a significant lack of focused self-management and, compared with other chronic conditions, there appear to be few effective disease-specific tailored educational programmes for psoriasis.
authors.affiliation: Medical Faculty, Department of Health Sciences, Institute of Health and Society, University of Oslo, Norway; Section for Climate Therapy, Integration and International Collaboration, Oslo University Hospital, Norway. Electronic address: m.h.larsen@medisin.uio.no.
authors.forename: Marie Hamilton
authors.initials: MH
authors.lastname: Larsen
authors.affiliation: Medical Faculty, Department of Health Sciences, Institute of Health and Society, University of Oslo, Norway; National Resource Centre for Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Norway. Electronic address: k.b.hagen@medisin.uio.no.
authors.forename: Kåre Birger
authors.initials: KB
authors.lastname: Hagen
authors.affiliation: Section for Climate Therapy, Integration and International Collaboration, Oslo University Hospital, Norway; The Department of Dermatology, Oslo University Hospital, Norway. Electronic address: a.l.krogstad@ous-hf.no.
authors.forename: Anne-Lene
authors.initials: AL
authors.lastname: Krogstad
authors.affiliation: Medical Faculty, Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Norway. Electronic address: eline.aas@medisin.uio.no.
authors.forename: Eline
authors.initials: E
authors.lastname: Aas
authors.affiliation: Medical Faculty, Department of Health Sciences, Institute of Health and Society, University of Oslo, Norway. Electronic address: a.k.wahl@medisin.uio.no.
authors.forename: Astrid Klopstad
authors.initials: AK
authors.lastname: Wahl
mesh_terms: D006801:Humans; D010353:Patient Education as Topic; D011565:Psoriasis / Q000628:therapy*; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012648:Self Care
keywords: Patient education; Psoriasis; Review; Self-management