title: Patient perspectives in the management of psoriasis: results from the population-based Multinational Assessment of Psoriasis and Psoriatic Arthritis Survey.
abstract: BACKGROUND
  Available psoriasis surveys offer valuable information about psoriasis and psoriatic arthritis (PsA), but are limited by methodology or enrollment requirements.
  
  
  OBJECTIVE
  To further the understanding of the unmet needs of psoriasis and PsA patients.
  
  
  METHODS
  This was a large, multinational, population-based survey of psoriasis and/or PsA patients in North America and Europe. Patients were selected by list-assisted random digit dialing and did not have to currently be under the care of a health care provider, a patient organization member, or receiving treatment; 139,948 households were screened and 3426 patients completed the survey.
  
  
  RESULTS
  The prevalence of psoriasis/PsA ranged from 1.4% to 3.3%; 79% had psoriasis alone and 21% had PsA. When rating disease severity at its worst, 27% (psoriasis) and 53% (PsA ± psoriasis) of patients rated it as severe. Psoriasis patients indicated that their most bothersome signs or symptoms were itching (43%), scales (23%), and flaking (20%). Of psoriasis patients, 45% had not seen a physician in a year; >80% of psoriasis patients with ≥ 4 palms body surface area and 59% of PsA patients were receiving no treatment or topical treatment only. Of patients who had received oral or biologic therapy, 57% and 45%, respectively, discontinued therapy, most often for safety/tolerability reasons and a lack/loss of efficacy.
  
  
  CONCLUSIONS
  The survey lacked a control group, did not account for ethnic and health care system differences across countries, and was limited by factors associated with any patient survey, including accurate recall and interpretation of questions.
  
  
  CONCLUSIONS
  Several identified unmet needs warrant additional attention and action, including improved severity assessment, PsA screening, patient awareness, and treatment options.
authors.affiliation: The Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: mark.lebwohl@mountsinai.org.
authors.forename: Mark G
authors.initials: MG
authors.lastname: Lebwohl
authors.affiliation: Sorbonne Paris Cité Univ Paris Diderot, Department of Dermatology, APHP Saint-Louis Hospital, Paris, France.
authors.forename: Hervé
authors.initials: H
authors.lastname: Bachelez
authors.affiliation: St John's Institute of Dermatology, Division of Genetics and Molecular Medicine, King's College, London, United Kingdom.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Barker
authors.affiliation: University of Verona, Verona, Italy.
authors.forename: Giampiero
authors.initials: G
authors.lastname: Girolomoni
authors.affiliation: University of California, San Diego School of Medicine, La Jolla, California.
authors.forename: Arthur
authors.initials: A
authors.lastname: Kavanaugh
authors.affiliation: Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Richard G
authors.initials: RG
authors.lastname: Langley
authors.affiliation: Department of Dermatology, Toulouse University and Larrey Hospital, Toulouse, France.
authors.forename: Carle F
authors.initials: CF
authors.lastname: Paul
authors.affiliation: Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: Lluís
authors.initials: L
authors.lastname: Puig
authors.affiliation: Sclderm Research Institute and Dermatologikum Hamburg, Hamburg, Germany.
authors.forename: Kristian
authors.initials: K
authors.lastname: Reich
authors.affiliation: Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: Peter C M
authors.initials: PC
authors.lastname: van de Kerkhof
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015535:Arthritis, Psoriatic / Q000453:epidemiology / Q000628:therapy; D005060:Europe / Q000453:epidemiology; D005260:Female; D014943:Global Health; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009656:North America / Q000453:epidemiology; D017060:Patient Satisfaction; D011565:Psoriasis / Q000453:epidemiology / Q000628:therapy*; D011788:Quality of Life; D055815:Young Adult
keywords: health survey; patient satisfaction; psoriasis; psoriatic arthritis; quality of life; questionnaires