title: US Perspectives in the Management of Psoriasis and Psoriatic Arthritis: Patient and Physician Results from the Population-Based Multinational Assessment of Psoriasis and Psoriatic Arthritis (MAPP) Survey.
abstract: BACKGROUND
  The Multinational Assessment of Psoriasis and Psoriatic Arthritis (MAPP), a population-based survey of patients, dermatologists, and rheumatologists, was conducted for better understanding of the unmet needs of psoriasis and psoriatic arthritis (PsA) patients.
  
  
  OBJECTIVE
  To report results from US physicians and patients.
  
  
  METHODS
  Adults were contacted by household telephone, using random digit dialing, and asked to participate if they had ever been diagnosed with psoriasis or PsA. Physicians were identified through national databases and contacted through random sampling methods.
  
  
  RESULTS
  In the USA, 1005 patients, 101 dermatologists, and 100 rheumatologists were surveyed. PsA had been diagnosed in 270 patients (26.9%). Of those with psoriasis alone, fewer than 60% (versus 85.6% of PsA patients) had seen a healthcare provider within 12 months. Joint pain was reported by 51.8% of psoriasis patients without a diagnosis of PsA, and 37.6% of dermatologists cited their greatest challenge in managing PsA patients as being differentiating PsA from other arthritic diseases. Itching was reported by 36% of psoriasis patients versus 12% of dermatologists as the most important factor contributing to disease severity. Patients reported lower rates of current treatment than did dermatologists and rheumatologists. Conventional oral and biologic therapies were used by 24.9 and 17.7% of patients, respectively. Among patients who had received injectable biologics, treatment dissatisfaction was related to long-term safety/tolerability, injection-related anxiety/fear, and cost.
  
  
  CONCLUSIONS
  This large, population-based survey identified unmet needs in the management of psoriasis and PsA patients in the USA, including assessment of disease severity, PsA diagnosis, undertreatment, and satisfaction with therapy.
authors.affiliation: The Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center, 5th Floor, 5 East 98th Street, Box 1048, New York, NY, 10029, USA. lebwohl@aol.com.
authors.forename: Mark G
authors.initials: MG
authors.lastname: Lebwohl
authors.affiliation: School of Medicine, University of California, San Diego, La Jolla, CA, USA.
authors.forename: Arthur
authors.initials: A
authors.lastname: Kavanaugh
authors.affiliation: Department of Dermatology, University of Southern California, Los Angeles, CA, USA.
authors.forename: April W
authors.initials: AW
authors.lastname: Armstrong
authors.affiliation: Department of Dermatology, Eastern Virginia Medical School, Norfolk, VA, USA.
authors.forename: Abby S
authors.initials: AS
authors.lastname: Van Voorhees
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015535:Arthritis, Psoriatic / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D001688:Biological Products / Q000627:therapeutic use; D005260:Female; D006301:Health Services Needs and Demand / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010361:Patients; D010820:Physicians; D011565:Psoriasis / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D001688:Biological Products