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June 2012

A Patient Decision Aid for Psoriasis Based on Current Clinical Practice Guidelines

Author Affiliations

Author Affiliations: Department of Medicine, University of Western Ontario, London (Dr Tan), and Department of Psychology, University of Windsor, Windsor (Ms Wolfe), Ontario, Canada.

Arch Dermatol. 2012;148(6):718-723. doi:10.1001/archdermatol.2012.36

Objective To develop a patient decision aid (PDA) for psoriasis with content derived from current clinical practice guidelines.

Design This PDA was developed in accordance with international patient decision aid standards. Primary sources of treatment outcome information were English-language, evidence-based clinical practice guidelines for plaque psoriasis published between January 1, 2006, and December 31, 2010.

Setting Patients with psoriasis from a private practice in Windsor, Ontario, Canada, and a focus group of dermatologists across Canada.

Participants Focus groups of dermatologists (n = 5) and patients with psoriasis (n = 7) were convened to provide feedback on balance, clarity, practicality, and items for inclusion and exclusion.

Main Outcome Measures Physician's global assessment, overall lesional assessment, and 75% reduction in Psoriasis Area and Severity Index.

Results Efficacy measures selected to reflect good control in the PDA were physician's global assessment (clear or almost clear) or overall lesional assessment (none or very mild) for topical agents and 75% reduction in Psoriasis Area and Severity Index for phototherapy and systemic agents. Where available, outcomes for serious adverse effects were displayed figuratively with efficacy measures. Deliberative questions for self-completion and a values clarification exercise were also incorporated.

Conclusion This psoriasis PDA was developed according to international standards based on content derived from current clinical practice guidelines.