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Psoriasis in Israel: demographic, epidemiology, and healthcare services utilization
Author(s) -
Shalom Guy,
Zisman Devy,
Babaev Meir,
Horev Amir,
Tiosano Shmuel,
Schonmann Yochai,
Comaneshter Doron,
Cohen Ar D.
Publication year - 2018
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1111/ijd.14130
Subject(s) - medicine , psoriasis , epidemiology , health care , pharmacy , dermatology , family medicine , economics , economic growth
Background Updated data regarding the epidemiology of psoriasis and related healthcare utilization are lacking. Objective To investigate the epidemiology, comorbidities, healthcare services utilization, and drug use in a large group of patients with psoriasis from Clalit Health Services ( CHS ) database. Methods A controlled cross‐sectional study was performed. Case patients were defined when there was at least one documented diagnosis of psoriasis registered by a CHS dermatologist between the years 1998–2016. The extracted data included metabolic, cardiovascular and psychiatric comorbidities; community clinic visits; in‐ and outpatient services utilization profiles and drug use data, which included pharmacy claims of topical and systemic treatments, including phototherapy and climatotherapy. Comparative analysis was performed by a univariate and multivariate analysis, adjusting for age, gender, obesity, and smoking. Results The study included 118,680 patients with psoriasis (prevalence of 2.69%) and 118,680 age‐ and gender‐matched controls. Patients with psoriasis had increased prevalence of metabolic, cardiovascular, and psychiatric illnesses. Psoriasis was significantly associated with an increased healthcare utilization. The mean ( SD ) number of annual dermatologist clinic visits and emergency room visits was 7.2 ± 12.4 and 2.9 ± 7.7 in psoriasis patients as compared to 2.9 ± 7.9 and 2.7 ± 7.4 in the control group ( P < 0.001). Topical steroids were the most applied treatment in psoriasis patients (15.5%), and topical vitamin D analogs were second in use (14.6%). Traditional systemic treatment for psoriasis was used in 3.8% of the patients, and biologic treatments were used in 1.6% of the patients. Conclusions Our study quantifies healthcare services utilization and drug use in patients with psoriasis.