Medicinal Treatment of Elderly Psoriasis Patients Before and After Entering a Nursing Home

Overview

Journal Healthcare (Basel)

Specialty Health Services

Date 2022 Sep 23

PMID 36141342

Authors

Jana Petersen

Claudia Garbe

Sandra Wolf

Brigitte Stephan

Matthias Augustin

Kristina Hagenstrom

Affiliations

Soon will be listed here.

Abstract

Psoriasis (PS) is a chronic inflammatory skin disease, and it increasingly appears also in the elderly population. There is a rising interest in drug therapy for PS, especially for people receiving care in nursing homes (NH). Which PS-related drugs are prescribed in the time before nursing home admission (NHA), and to what extent does the supply of drugs change after NHA? Which specialties prescribe PS-related drugs? Statutory health insurance data were examined for people with PS, aged ≥ 65 years, who were newly admitted to a NH in the period 2011-2014 and observed for one year before and after NHA. Changes in prescription prevalence (pre-post comparison) were examined for significant differences. Prescriptions of PS-relevant drugs were measured by defined daily dose and stratified according to the prescribing specialist group. The analysis included 718 insured persons with PS (76.2% female, mean age 83.3 years). Systemic therapeutics played a minor role (pre: 2.6% vs. post: 2.1%) in drug therapy. Topical steroids had a high share of about 40% in the pre-post comparison. Overall, the proportion of people with PS who received treatment remained at a comparable level before and after NHA. A structured assessment of the skin is crucial, specifically in people with cognitive impairment.

References

Swart E, Gothe H, Geyer S, Jaunzeme J, Maier B, Grobe T . [Good Practice of Secondary Data Analysis (GPS): guidelines and recommendations]. Gesundheitswesen. 2015; 77(2):120-6. DOI: 10.1055/s-0034-1396815. View

Dalgard F, Gieler U, Tomas-Aragones L, Lien L, Poot F, Jemec G . The psychological burden of skin diseases: a cross-sectional multicenter study among dermatological out-patients in 13 European countries. J Invest Dermatol. 2014; 135(4):984-991. PMC: 4378256. DOI: 10.1038/jid.2014.530. View

Smith E, Fleischer Jr A, Feldman S . Demographics of aging and skin disease. Clin Geriatr Med. 2001; 17(4):631-41, v. DOI: 10.1016/s0749-0690(05)70090-2. View

Makrantonaki E, Liakou A, Eckardt R, Zens M, Steinhagen-Thiessen E, Zouboulis C . [Skin diseases in geriatric patients. Epidemiologic data]. Hautarzt. 2012; 63(12):938-46. DOI: 10.1007/s00105-012-2466-0. View

Di Caprio R, Caiazzo G, Cacciapuoti S, Fabbrocini G, Scala E, Balato A . Safety concerns with current treatments for psoriasis in the elderly. Expert Opin Drug Saf. 2020; 19(4):523-531. DOI: 10.1080/14740338.2020.1728253. View

Tatu A, Elisei A, Chioncel V, Miulescu M, Nwabudike L . Immunologic adverse reactions of β-blockers and the skin. Exp Ther Med. 2019; 18(2):955-959. PMC: 6639944. DOI: 10.3892/etm.2019.7504. View

Kostovic K, Zuzul K, Ceovic R, Bukvic Mokos Z . Psoriasis in the mature patient: Therapeutic approach in the era of biologics. Clin Dermatol. 2018; 36(2):222-230. DOI: 10.1016/j.clindermatol.2017.10.013. View

Hoffmann F, Meinecke P, Freitag M, Glaeske G, Schulze J, Schmiemann G . Who gets dipyrone (metamizole) in Germany? Prescribing by age, sex and region. J Clin Pharm Ther. 2015; 40(3):285-8. DOI: 10.1111/jcpt.12261. View

Parslew R, Traulsen J . Efficacy and local safety of a calcipotriol/ betamethasone dipropionate ointment in elderly patients with psoriasis vulgaris. Eur J Dermatol. 2005; 15(1):37-9. View

10.

Kottner J, Rahn Y, Blume-Peytavi U, Lahmann N . Skin care practice in German nursing homes: a German-wide cross-sectional study. J Dtsch Dermatol Ges. 2013; 11(4):329-36. DOI: 10.1111/ddg.12008. View

11.

Augustin M, Spehr C, Radtke M, Boehncke W, Luger T, Mrowietz U . German psoriasis registry PsoBest: objectives, methodology and baseline data. J Dtsch Dermatol Ges. 2014; 12(1):48-57. DOI: 10.1111/ddg.12233. View

12.

Kamel J, Yamauchi P . Managing Mild-to-Moderate Psoriasis in Elderly Patients: Role of Topical Treatments. Drugs Aging. 2017; 34(8):583-588. DOI: 10.1007/s40266-017-0480-8. View

13.

Grozdev I, Van Voorhees A, Gottlieb A, Hsu S, Lebwohl M, Bebo Jr B . Psoriasis in the elderly: from the Medical Board of the National Psoriasis Foundation. J Am Acad Dermatol. 2011; 65(3):537-545. DOI: 10.1016/j.jaad.2010.05.014. View

14.

Le A, Torres T . New Topical Therapies for Psoriasis. Am J Clin Dermatol. 2021; 23(1):13-24. DOI: 10.1007/s40257-021-00649-w. View

15.

Schulze J, Freitag M, Glaeske G, Schmiemann G, Hoffmann F . [Pain medication in nursing home residents with and without cancer. Most frequently with metamizole]. Schmerz. 2015; 29(3):276-84. DOI: 10.1007/s00482-015-0003-7. View

16.

Phan C, Sigal M, Esteve E, Reguiai Z, Barthelemy H, Beneton N . Psoriasis in the elderly: epidemiological and clinical aspects, and evaluation of patients with very late onset psoriasis. J Eur Acad Dermatol Venereol. 2014; 30(1):78-82. DOI: 10.1111/jdv.12850. View

17.

Kratzsch D, Treudler R . Dermatologic therapy in geriatric patients. J Dtsch Dermatol Ges. 2014; 12(8):653-63. DOI: 10.1111/ddg.12365. View

18.

Enamandram M, Kimball A . Psoriasis epidemiology: the interplay of genes and the environment. J Invest Dermatol. 2013; 133(2):287-9. DOI: 10.1038/jid.2012.434. View

19.

Augustin M, Kruger K, Radtke M, Schwippl I, Reich K . Disease severity, quality of life and health care in plaque-type psoriasis: a multicenter cross-sectional study in Germany. Dermatology. 2008; 216(4):366-72. DOI: 10.1159/000119415. View

20.

Balato N, Patruno C, Napolitano M, Patri A, Ayala F, Scarpa R . Managing moderate-to-severe psoriasis in the elderly. Drugs Aging. 2014; 31(4):233-8. DOI: 10.1007/s40266-014-0156-6. View