BACKGROUND:Psoriasis has been linked with cardiovascular risk factors (CVRFs), including the metabolic syndrome, yet many patients with psoriasis remain unscreened. OBJECTIVE:To assess the reasons for lack of screening for CVRFs in psoriasis patients, and the impact of an education programme targeting these deficiencies. METHODS:All patients with psoriasis, regardless of severity, and all dermatologists working at the National Skin Centre (NSC) in Singapore were surveyed over a 2-month period on their attitudes and knowledge regarding psoriasis and cardiovascular risk. This was followed by a targeted programme which was implemented over 2 months to address these identified deficiencies. Patients and doctors were surveyed a second time to assess the effects of the intervention. RESULTS:Obstacles to screening included lack of patient knowledge, patients not considering screening important, and lack of time during the clinic consultation. After the intervention, there was a significant increase in the proportion of patients who were aware of increased cardiovascular risk in psoriasis (33.0% to 62%), with more patients attending screening (39.1% to 63.2%). While the level of doctors' knowledge did not significantly increase, there was an increase in the proportion of patients who were screened post-intervention (37.1% to 66.2%), and more doctors reported that they were more likely to screen psoriatic patients from an earlier age (30.2% to 58.1%). CONCLUSIONS:The obstacles in implementing universal screening for CVRFs in psoriasis patients stem from patient, doctor and system factors. A comprehensive programme targeting all aspects of this ecosystem helps to achieve holistic care for patients with psoriasis.

译文

背景:牛皮癣已与包括代谢综合征在内的心血管危险因素(CVRFs)相关联,但许多牛皮癣患者仍未接受筛查。
目的:评估缺乏对银屑病患者进行CVRF筛查的原因,以及针对这些缺陷的教育计划的影响。
方法:对所有牛皮癣患者(不论严重程度)以及在新加坡国家皮肤中心(NSC)工作的所有皮肤科医生进行了为期2个月的调查,了解他们对牛皮癣和心血管疾病的态度和知识。随后是针对性计划,该计划在两个月内实施,以解决这些已发现的缺陷。对患者和医生进行了第二次调查,以评估干预措施的效果。
结果:筛查的障碍包括缺乏患者知识,不认为筛查重要的患者以及在临床咨询期间缺乏时间。干预后,意识到牛皮癣的心血管风险增加的患者比例显着增加(33.0%至62%),而接受筛查的患者更多(39.1%至63.2%)。尽管医生的知识水平没有显着提高,但接受干预后筛查的患者比例有所增加(37.1%至66.2%),并且更多的医生报告说他们更有可能从银屑病筛查银屑病患者年龄较早(30.2%至58.1%)。
结论:在牛皮癣患者中进行CVRFs普查的障碍来自患者,医生和系统因素。针对该生态系统各个方面的综合计划有助于为牛皮癣患者提供整体护理。

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