MedWire News: Researchers have identified eight guideline-based indicators of quality of care in psoriasis that they believe could be used to implement treatment guidelines for the skin disease.

“No systematically developed and empirically tested indicators have been published in dermatology to date,” note Marc Radtke (University Medical Center Hamburg-Eppendorf, Germany) and colleagues.

To identify potential quality indicators, the team extracted indicators of process and outcome quality from the international research literature and from the German Board of Scientific Medical Societies guideline for the treatment of psoriasis vulgaris.

An interdisciplinary expert committee reviewed the 57 indicators of process quality and 12 indicators of outcome quality identified in the literature and guidelines.

A refined list of eight indicators was then validated with data from two nationwide studies on psoriasis care carried out in 2005 and 2007 involving 1511 and 2009 patients, respectively.

The eight indicators were mean Psoriasis Severity and Area Index (PASI) score, mean score on the Dermatology quality of life Index (DLQI), proportion of patients with PASI >20, proportion with DLQI>10, proportion who had received treatment with systemics, proportion with PASI >20 and concurrently treated with systemics, proportion who received inpatient treatment in the past 5 years and mean number of working days lost.

The researchers report in the journal Dermatology that the data for the indicators could be extracted without any problems from the two studies and the comparison of indicators of quality of care in 2005 and 2007 demonstrated that the indicators were sensitive to change.

“The use of agreed thresholds in psoriasis care based on these quality indicators could be addressed,” say Radtke et al.

“If formulated as a binding goal of health care, these thresholds could improve the performance of psoriasis care markedly.”

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