Barriers and suggestions for improving the implementation of guidelines in the systemic treatment of moderate to severe psoriasis: A literature review

IF 3.1 4区 医学 Q2 DERMATOLOGY
V. Kalita, D. Abs, A.-C. Bursztejn
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引用次数: 0

Abstract

Background

Despite the availability of a wide range of therapies for the systemic treatment of moderate to severe psoriasis, many psoriasis patients do not receive adequate treatment, suggesting that guidelines may not be correctly applied by physicians.

Objectives

The aim of this study was to analyze data on physicians’ implementation of, and reasons for noncompliance with, guidelines for the systemic treatment of moderate to severe psoriasis.

Methods

We conducted a systematic literature review according to the Preferred Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched the PubMed and Embase databases for studies on guideline adherence in the systemic treatment of moderate to severe psoriasis. All eligible articles were retrieved in full text and the relevant references of retrieved articles were included.

Results

A total of 20 studies were selected. Four studies investigated knowledge of the guidelines, six studies examined their application, and five studies focused on the various barriers to implementation. Finally, five studies discussed ways to improve implementation. Several studies on the quality of psoriasis care have revealed discrepancies between the reality and the optimal care described in national and international guidelines.

Conclusion

Various barriers to implementation of recommendations exist, such as economic barriers, lack of dermatologic orientation towards, lack of knowledge of recommendations by other specialists, lack of applicability, and country- and practice-specific features (e.g., different benefit/risk ratios, different reimbursement rates and conditions). This review can help the everyday practitioner to better understand these barriers, which will have a direct impact on improving the quality of life of psoriasis patients.

改善中重度银屑病系统治疗指南实施的障碍和建议:文献综述
背景尽管目前有多种疗法可用于中重度银屑病的系统治疗,但许多银屑病患者并未得到适当的治疗,这表明医生可能并未正确应用指南。我们在 PubMed 和 Embase 数据库中检索了有关中度至重度银屑病系统治疗指南依从性的研究。我们检索了所有符合条件的文章全文,并纳入了检索文章的相关参考文献。四项研究调查了对指南的了解情况,六项研究考察了指南的应用情况,五项研究关注了指南实施过程中遇到的各种障碍。最后,五项研究讨论了改进实施的方法。几项关于银屑病治疗质量的研究显示,现实情况与国家和国际指南中描述的最佳治疗之间存在差异。结论建议的实施存在各种障碍,如经济障碍、缺乏皮肤病学方向、其他专家对建议缺乏了解、缺乏适用性以及国家和实践的特殊性(如不同的收益/风险比、不同的报销比例和条件)。本综述有助于日常从业人员更好地了解这些障碍,这将对改善银屑病患者的生活质量产生直接影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.40
自引率
0.00%
发文量
70
审稿时长
81 days
期刊介绍: Les Annales de dermatologie sont le rendez-vous mensuel incontournable de toute la dermatologie francophone, grâce à leur comité de rédaction qui assure une sélection rigoureuse des articles selon les normes de l''édition scientifique internationale. Une revue didactique, véritable aide à la pratique médicale quotidienne Pour compléter et enrichir la partie scientifique, la rubrique Formation médicale continue propose aux lecteurs des textes didactiques et interactifs (Cas pour diagnostic, Notes de pharmacovigilance, la Question du praticien, Dermatologie chirurgicale, la Sélection bibliographique du mois...) qui les font bénéficier d''une formation post-universitaire diversifiée et de qualité. La revue consacre également un espace pour la publication de questions des lecteurs auxquelles des experts apportent une réponse.
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