Aldeen T and Powell R
Psoriasis Management; Patient Feedback and Healthcare Limitations
Background:  Psoriasis  is  a  lifelong,  incurable,  disfiguring  skin  disease. It has been associated with metabolic and psychological  comorbidities  and  up  to  one  third  of  patients  developed  psoriatic   arthritis.  The  management  of  the  disease  and  its  comorbidities   require  careful  assessment  of  the  patient’s  personal,  social,  and   emotional  status.  Although,  assessment  tools  have  been  used   to  measure  psoriasis  severity,  a  patient’s  subjective  view  on  the   disease  is  an  emotional  morbidity  that  cannot  be  easily  assessed   by using such tools. The limited consultation time and resource in  a  district  hospital  can  prevent  psoriasis  sufferers  from  expressing   their feelings and challenges with the disease.
Objective:  We conducted a postal feedback survey from patients  receiving  their  psoriasis  care  in  a  district  hospital  to  assess  their   physical and emotional morbidities and to capture their views and  perception on the healthcare service they received. 
Method:  A health quality questionnaire was posted to 112 male and  female psoriasis patients aged 18 years and above, receiving their  care  in  a  district  hospital.  Patients’  postal  address  was  obtained   from the Dermatology Department’s database at the same hospital.  The  results  of  the  survey  were  generated  by  using  spread  sheet   and Stats Direct v3.0.167. 
Results:  Psoriasis affected the quality of life of 97.8% patients and  71.1% of the patients suffer from comorbidities. Around 44% of the  patients  developed  depression  after  the  onset  of  the  disease  and   some  of  them  were  living  without  family  or  social  support.  Stress   was the main triggering factor for psoriasis flare and 55.5% wished  to  receive  more  information  and  counselling  on  psoriasis  by  their   health provider.  
Conclusion:   District  hospitals  may  have  limited  resources  to   comply with the national recommendations of psoriasis care. Local  and  regional  multi-disciplinary  approach  is  needed  for  effective   management of psoriasis and its comorbidities.