Age-based treatment differences in and reluctance to treating older adults with systemic antipsoriatic therapy – a mixed-method pilot study
Background Evidence-based guidance in older adults (≥65 years) with psoriasis is sparse and undertreatment might be present. Objectives To assess prescribing patterns, comfort levels, barriers and needs of dermatologists when treating older adults with systemic antipsoriatic therapy. Methods A mixed...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2022-10-01
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| Series: | Journal of Dermatological Treatment |
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| Online Access: | http://dx.doi.org/10.1080/09546634.2022.2089330 |
| _version_ | 1797683486224547840 |
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| author | Elke L. M. ter Haar Marcia Tummers Ewald M. Bronkhorst Peter C. M. van de Kerkhof Elke M. G. J. de Jong Satish F. K. Lubeek |
| author_facet | Elke L. M. ter Haar Marcia Tummers Ewald M. Bronkhorst Peter C. M. van de Kerkhof Elke M. G. J. de Jong Satish F. K. Lubeek |
| author_sort | Elke L. M. ter Haar |
| collection | DOAJ |
| description | Background Evidence-based guidance in older adults (≥65 years) with psoriasis is sparse and undertreatment might be present. Objectives To assess prescribing patterns, comfort levels, barriers and needs of dermatologists when treating older adults with systemic antipsoriatic therapy. Methods A mixed-methods design was used including a survey among all Dutch dermatologists and residents, followed by semi-structured interviews. Results Most of the survey respondents applied systemic treatment to the same extent in older versus younger patients (n = 49; 67.1%) and weren’t reluctant prescribing systemic therapy (n = 50; 68.5%) in older adults. However, 26% (n = 19) of the respondents treated older adults less often with systemic therapy compared to younger patients and 68.1% (n = 49) performed additional actions in older adults, e.g. intensified monitoring or dose reduction. Based on the survey and interviews (n = 10), the main reasons for these age-based treatment differences were comorbidity, comedication, and fear of adverse events. More evidence-based guidance, education, and time to assess older adults were identified as most important needs, especially regarding frailty screening. Conclusions Age-based treatment differences in and reluctance to treating older adults with systemic antipsoriatic therapy were common. There is a need for more evidence-based guidance, education, and consultation time, to improve treatment in this growing population. |
| first_indexed | 2024-03-12T00:15:08Z |
| format | Article |
| id | doaj.art-a08dbd3cf5b54da49f48b98b21b151ad |
| institution | Directory Open Access Journal |
| issn | 0954-6634 1471-1753 |
| language | English |
| last_indexed | 2024-03-12T00:15:08Z |
| publishDate | 2022-10-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Dermatological Treatment |
| spelling | doaj.art-a08dbd3cf5b54da49f48b98b21b151ad2023-09-15T14:28:52ZengTaylor & Francis GroupJournal of Dermatological Treatment0954-66341471-17532022-10-013372983299010.1080/09546634.2022.20893302089330Age-based treatment differences in and reluctance to treating older adults with systemic antipsoriatic therapy – a mixed-method pilot studyElke L. M. ter Haar0Marcia Tummers1Ewald M. Bronkhorst2Peter C. M. van de Kerkhof3Elke M. G. J. de Jong4Satish F. K. Lubeek5Department of Dermatology, Radboud University Medical CenterDepartment for Health Evidence, Radboud University Medical CenterDepartment for Health Evidence, Radboud University Medical CenterDepartment of Dermatology, Radboud University Medical CenterDepartment of Dermatology, Radboud University Medical CenterDepartment of Dermatology, Radboud University Medical CenterBackground Evidence-based guidance in older adults (≥65 years) with psoriasis is sparse and undertreatment might be present. Objectives To assess prescribing patterns, comfort levels, barriers and needs of dermatologists when treating older adults with systemic antipsoriatic therapy. Methods A mixed-methods design was used including a survey among all Dutch dermatologists and residents, followed by semi-structured interviews. Results Most of the survey respondents applied systemic treatment to the same extent in older versus younger patients (n = 49; 67.1%) and weren’t reluctant prescribing systemic therapy (n = 50; 68.5%) in older adults. However, 26% (n = 19) of the respondents treated older adults less often with systemic therapy compared to younger patients and 68.1% (n = 49) performed additional actions in older adults, e.g. intensified monitoring or dose reduction. Based on the survey and interviews (n = 10), the main reasons for these age-based treatment differences were comorbidity, comedication, and fear of adverse events. More evidence-based guidance, education, and time to assess older adults were identified as most important needs, especially regarding frailty screening. Conclusions Age-based treatment differences in and reluctance to treating older adults with systemic antipsoriatic therapy were common. There is a need for more evidence-based guidance, education, and consultation time, to improve treatment in this growing population.http://dx.doi.org/10.1080/09546634.2022.2089330psoriasisolder adultsgeriatric psoriasistreatment patternstreatment-reluctance |
| spellingShingle | Elke L. M. ter Haar Marcia Tummers Ewald M. Bronkhorst Peter C. M. van de Kerkhof Elke M. G. J. de Jong Satish F. K. Lubeek Age-based treatment differences in and reluctance to treating older adults with systemic antipsoriatic therapy – a mixed-method pilot study Journal of Dermatological Treatment psoriasis older adults geriatric psoriasis treatment patterns treatment-reluctance |
| title | Age-based treatment differences in and reluctance to treating older adults with systemic antipsoriatic therapy – a mixed-method pilot study |
| title_full | Age-based treatment differences in and reluctance to treating older adults with systemic antipsoriatic therapy – a mixed-method pilot study |
| title_fullStr | Age-based treatment differences in and reluctance to treating older adults with systemic antipsoriatic therapy – a mixed-method pilot study |
| title_full_unstemmed | Age-based treatment differences in and reluctance to treating older adults with systemic antipsoriatic therapy – a mixed-method pilot study |
| title_short | Age-based treatment differences in and reluctance to treating older adults with systemic antipsoriatic therapy – a mixed-method pilot study |
| title_sort | age based treatment differences in and reluctance to treating older adults with systemic antipsoriatic therapy a mixed method pilot study |
| topic | psoriasis older adults geriatric psoriasis treatment patterns treatment-reluctance |
| url | http://dx.doi.org/10.1080/09546634.2022.2089330 |
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