Quality of life and contact with healthcare systems among patients with psoriasis and psoriatic arthritis: results from the NORdic PAtient survey of Psoriasis and Psoriatic arthritis (NORPAPP)

A Duvetorp,M Østergaard,L Skov,O Seifert,K Danielsen,Lars Iversen,K S Tveit

doi:10.1007/s00403-019-01906-z

Abstract

Psoriasis (skin psoriasis, PsO) is a chronic inflammatory condition. In about one-third of cases, the joints are affected (psoriatic arthritis, PsA). Both conditions, especially PsA, profoundly impact patients’ health-related quality of life (HRQoL). To describe the impact of psoriasis on HRQoL and patients’ contact with the healthcare system in Sweden, Denmark, and Norway, the NORdic PAtient survey of Psoriasis and Psoriatic arthritis (NORPAPP) asked 22,050 adults randomly selected in Sweden, Denmark and Norway if they had psoriasis. 1264 individuals who reported physician-diagnosed PsO/PsA were invited to the full survey; 1221 responded (74.6% diagnosed with PsO alone; 25.4% with PsA ± PsO). Respondents with PsA most frequently consulted a rheumatologist; however, 14.3% had never seen a rheumatologist. Respondents with PsO alone most frequently consulted a general practitioner and 10.7% had never seen a dermatologist (although those with severe symptoms visited dermatologists more often). Negative impacts on HRQoL were reported by 38.1% of respondents with PsO [mostly limitations on clothing (22.6%), sleep disorders (16%), and depression/anxiety (16%)] and by 73% of respondents with PsA [mostly limitations on clothing (41.8%), sports/leisure (44.0%), or daily routine (45.1%) and sleeping disorders]. Absence from work/education was more common with PsA ± PsO (51.9%) than PsO alone (15.1%). In this survey in Sweden, Denmark, and Norway, the impact of psoriasis on the respondents’ HRQoL was profound and was greater for PsA than for PsO, as was sickness absence. Sleeping disorders and depression were common and should not be overlooked.

Highlights

Psoriasis (PsO) is a chronic inflammatory skin condition that, in many cases, requires life-long monitoring and management
The Multinational Assessment of Psoriasis and Psoriatic Arthritis (MAPP) survey confirmed the profound impact of PsO and psoriatic arthritis (PsA) on patients’ daily lives, but did not include any Nordic countries [12]
The healthcare professional (HCP) most frequently seen for PsO symptoms by respondents with PsO alone were general practitioner (GP) (35.5%) rather than dermatologists (29.5%)

Summary

Introduction

Psoriasis (PsO) is a chronic inflammatory skin condition that, in many cases, requires life-long monitoring and management. Archives of Dermatological Research (2019) 311:351–360 causing psoriatic arthritis (PsA) [8, 20] Both conditions, especially PsA, have a profound impact on the patient’s health-related quality of life (HRQoL), which is often underestimated [16]. An understanding of HRQoL in PsO/PsA, and its relationship with disease severity and response to treatment, is important in establishing better approaches to the care and treatment of patients with these conditions. The Multinational Assessment of Psoriasis and Psoriatic Arthritis (MAPP) survey confirmed the profound impact of PsO and PsA on patients’ daily lives, but did not include any Nordic countries [12]. The NORdic PAtient survey of Psoriasis and Psoriatic arthritis (NORPAPP) was conducted to gain a better understanding of the challenges faced by people living with PsO and PsA in Sweden, Denmark, and Norway [4]. The NORPAPP survey provided us with a large database of 1264 respondents with PsO and/or PsA

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