Patient-relevant Needs and Treatment Goals in Nail Psoriasis
1University Medical Centre Hamburg-Eppendorf, Institute for Health Services Research in Dermatology & Nursing, Hamburg, Germany
2Dermatologikum Hamburg, Germany
3University Medical Centre Hamburg-Eppendorf, Institute for Health Services Research in Dermatology & Nursing, Hamburg, Germany
BACKGROUND: Medical decisions should be based on patient needs. Objectives were to (a) develop treatment goal items for a questionnaire on needs and benefit in nail psoriasis treatment, (b) determine goal importance and (c) determine the association between goal importance and quality of life (QoL). METHODS: The study comprised 4 steps: qualitative patient survey on needs and burdens due to nail psoriasis (n=120); development of pilot items in expert group; empirical item testing (n=55); assessment in 6 countries (n=203). The percentage of patients rating goals as important was compared between different subgroups. Overall goal importance was correlated with disease-specific QoL. FINDINGS: The final NAPPA-PBI contained 24 treatment goals. Outcomes of particular importance related to manual dexterity and social interaction. Importance of many goals increased with disease severity, but not with age or disease duration. Goal importance and quality of life were associated (r=.61, p<.001), but patients with high QoL differed widely in goal importance, whereas most patients with low QoL stated high goal importance. DISCUSSION: Goal importance is not determined by subjective impairment only.