Management practice, and quality of life and its associated factors among ambulatory psoriatic patients attending Dermatological Center in Addis Ababa, Ethiopia

Abstract

Background: Psoriasis is a chronic inflammatory disease characterized by keratinocyte hyperproliferation and aberrant differentiation with great negative impact on patients’ quality of life (QoL). This study aimed at assessing management practice, and quality of life (QoL) and its associated factors among ambulatory psoriatic patients visiting All Africa Leprosy, Tuberculosis and Rehabilitation Training (ALERT) Center in Addis Ababa, Ethiopia.Materials and methods: A cross sectional study was conducted among 207 patients with psoriasis attending the dermatology clinic of ALERT Center in Addis Ababa, Ethiopia. Data were collected using structured questionnaire and patients’ chart review. Dermatology Life Quality Index (DLQI) was used to measure patients’ QoL. Data was analyzed entered and analyzed using Statistical Package for Social Sciences (SPSS®) version 25. Descriptive statistics like frequency, percent, mean and standard deviation were used to summarize patients’ characteristics while binary logistic regression was utilized to identify predictors of quality of life. Results: Among 207 study participants, 122(58.9%) were females. The mean age of the study population was 37.92(SD=14.86) years (ranging from 16 to 68 years). The mean age at which diagnosis of psoriasis made was 32.0(SD=13.7) years ranging from 10 to 62 years. The duration of the disease in 112(54.1%) patients were more than or equal to 5 years. Among study participants, the majority of them, 145(70.0%) had plaque psoriasis followed by sebopsoriasis, 24(11.6%). The majority of plaque psoriasis (80%) cases were managed by topical corticosteroids with or without salicylic acid or coal tar and only 21(14.5%) treated by methotrexate alone. Other forms of psoriasis were treated by only topical corticosteroids with or without salicylic acid. The mean DLQI was 6.25 corresponding to a moderate effect. Symptoms and feelings were the most affected domains of QoL. Factors associated with poor QoL were female gender [AOR=0.17 (95%CI: 0.06, 0.48)], low, above average and high family income ([AOR=0.12(95% CI: 0.02, 0.56)], [AOR=0.06(95% CI:0.01, 0.32)], and [AOR=0.03 (95% CI: 0.01, 0.22)]) respectively and primary education level [AOR=0.14 (95% CI: 0.03, 0.64)] while being on systemic therapy [AOR=4.26 (CI: 1.18, 15.35)] was predictor of better QoL.Conclusion: Topical corticosteroids were the mainstay of psoriasis treatment in our study. The mean DLQI was 6.25, corresponding to a moderate effect on QoL. Study participants with female gender, primary education level, and low, above average, and high monthly family income were considered to have worse QoL whereas receiving systemic therapy significantly associated with better QoL. Hence, future interventions targeting improving QoL and widening treatment options for psoriasis deemed to be necessary.

Health-related quality of life and its determinants among patients with psoriasis at a referral hospital in Northwest Ethiopia

“…According to the findings of this study, topical corticosteroids were prescribed to most psoriasis patients (68.2%), followed by systemic agents (22%), with betamethasone dipropionate being the most commonly prescribed (15.5%). This finding is consistent with previous Ethiopian research ( 16 , 36 ). However, according to Indian literature ( 37 ), clobetasol propionate is the most commonly prescribed medication.…”

“…This outcome resembles studies from India ( 23 ) and Malaysia ( 24 ), which discovered frequent to extremely significant effect estimates of 31.7 and 30%, respectively, in both countries. However, a study from Alert Hospital in Ethiopia ( 16 ) found that only 13% of participants had a significant impact from psoriasis, which is lower than the outcome of this study. However, studies from Egypt ( 21 ) and South Africa ( 25 ) found higher results of 60 and 50.7%, respectively.…”

“…This result is equivalent to that of earlier Chilean investigations ( 20 ) and Egypt ( 21 ), which reported mean DLQI scores of 14 and 12.2, respectively. In contrast, this outcome was higher than that of a study conducted in Ethiopia ( 16 ), with a mean score of 6.25, and in Turkey ( 22 ), with a mean score of 7.03. Even though the study was conducted in referral hospitals with better facilities and expertise, the patients' QOL was highly compromised.…”

“…✓ Monthly income (Ethiopian birr) is grouped as very low (≤860), low (861–1,500), average (1,501–3,000), above average (3,001–5,000), and high (≥5,001) ( 16 ).…”