Life quality assessment among patients with psoriasis

Introduction. Psoriasis is a systemic immune-associated disease with a multifactorial character with a predominance of genetic factors in its development that is characterized by accelerated separation of epidermal cells, a violation of their differentiation process, immune inflammatory interaction and synovial membranes, progression of external compliance and anti-inflammatory cytokines; frequent interference with the pathological process of the joints [1]. The epidemiological picture of psoriasis in the Russian Federation is characterized by a high prevalence and incidence of 217.4 per 100 000 population and 69.9 per 100 000 population, respectively [2]. Moreover, the absolute number of patients is more than 300 thousand people and continues to grow. Psoriasis usually debuts, usually at a young age, which is of great socio-economic importance in severe forms, limited ability to work patients, causes significant damage, among other things, cosmetic nature. In this connection, the aim of this study was to study the effect of this state on the aggravation of the patients' state of life before and after treatment in accordance with federal clinical recommendations on dermatovenereology since 2015.

Material and methods. The study included 37 patients with psoriasis who underwent in-patient treatment according to federal clinical recommendations in the dermatological department of the Republican Clinical Dermatological and Venereological Dispensary of the city of Simferopol during the period of exacerbation. The average age of the patients was 39.5 ± 8.5 years, 56.8% among them women, 43.2% - men. All patients questioned on two standard questionnaires - The Short Form-36 (SF-36) and the Dermatology Life Quality Index (DLQI). The firstone is a non-specific and serves as a tool for assessing the quality of life of patients. The second one designed for use in dermatological practice with the purpose of assessing the degree of negative impact of skin disease on various aspects of life, on the quality of life in general, and applies to determining the effectiveness of therapy in patients.

Results.In determining the dermatological quality of life index (DLQI) in patients at the time of admission to the hospital for treatment (at the peak of exacerbation), the average result was 23.6 on a scale of 0 to 30 among all patients, and was slightly higher in women - 26.7 , which was interpreted as an extremely strong negative impact on life. Analysis of data on the standard questionnaire SF-36 when entering the hospital (at the peak of exacerbation) revealed signs of a significant decrease in the quality of life in patients. Decrease in the total physical component of health to 57.1, the limitation of physical functioning to 75.1; Role functioning, due to physical condition - up to 54.3; intensity of pain - 88,4, an estimation of the general state of health - 61,8). The total psychological component of health was 61.2: mental health - 90.1; Role functioning due to emotional state - 92.6; social functioning - 74.8; life activity - 60.9. After the in-patient treatment in the dermatological department, the change in the dermatological quality of life index was determined to improve. Thus, the average value of this indicator decreased and became equal to 16.7, which corresponds to a decrease in the degree of impact of the disease on life from extremely strong to pronounce.

Assessment of the quality of life by SF-36 also showed a positive trend: the total physical component of health increased to 67.5. At the same time, all the parameters studied improved: physical functioning increased to 63.2; Role-based functioning, conditioned by physical condition - up to 54.8; the intensity of pain decreased to 52.6; the general state of health is 70.3. The total psychological component of health increased to 75.3, including mental health - up to 92.8; Role-based functioning, conditioned by emotional state - up to 97.2; social functioning - up to 88.5; life activity - up to 75.8.

Conclusion.The results of the study indicate a significant negative impact of the periods of exacerbation of psoriasis on the quality of life of patients. It significantly decreases when rational treatment in specialized stationary conditions according to the federal clinical recommendations for dermatology performed. However, it remains pronounced in comparison with the indices typical for the general population. The need remains to increase the control of therapy during periods outside the exacerbation of the disease. It is necessary for order to reduce the severity of the symptoms that cause physical discomfort, the development and application of measures to eliminate cosmetic harm to the appearance of a person, and improve the opportunities for sanatorium treatment and rehabilitation that would serve as the main sustainable improvement in the quality of life and health of patients.

 

References

  1. Aivazyan A.A., Psoriasis - an immunocompromised disease//Experimental and clinical dermatocosmetology. - 2014. - №2. - P. 36-38.
  2. Znamenskaya L.F., Melekhina L.E., Bogdanova E.V., Mineeva A.A., Morbidity and prevalence of psoriasis in the Russian Federation//Bulletin of Dermatology and Venereology. - 2012. - №5. - P. 20-29.
Year: 2017
City: Shymkent
Category: Medicine