COVID-19 Had Negative Impact on Psoriasis Care, Prescription Patterns, Survey Says

Egyptian dermatologists were asked about the effect of COVID‐19 on prescription patterns, appointment rescheduling, therapy decisions, and telemedicine use.

A recent study examined the impact of COVID-19 on the delivery of care for patients with psoriasis and found that there were delays in starting medications and in follow-up appointments, and that patients frequently stopped their medication without consulting their physician.

The observational, cross‐sectional study took place in Egypt from October 6-23, 2020, via an online questionnaire.

The survey evaluated the effect of COVID‐19 on prescription patterns, appointment rescheduling, therapy decisions, and telemedicine use, as well as perception of the pandemic's effect on health care delivery. It comprised 29 questions (21 multiple‐choice questions, 5 checkbox questions, and 3 free‐response questions).

The survey was delivered via email and social media; 197 dermatologists responded.

Just under half (47%) of dermatologists recruited were not using biologics for psoriasis treatment. When they were used, interleukin (IL)‐17 inhibitors were the most frequently prescribed, and IL-12/IL-23 inhibitors were the least used.

Most dermatologists delayed putting most patients on biologics unless therapy was urgently needed; phototherapy was the least delayed treatment.

For patients already receiving biologics or immunosuppressive treatment, most dermatologists favored continuation of therapy.

Dermatologists also reported an increase in prescriptions for topical medications (79.2%), natural sunlight (28.4%), acitretin (26.9%), and home UVB (21.3%).

However, there was a statistically significant difference in stopping certain therapies: phototherapy and methotrexate were the least likely to be discontinued (53.8% and 42.6%, respectively), followed by cyclosporine (37.1%). Biologics were only discontinued 17.3% during this time (P < .001).

Of physicians who did start their patients on biologics during the pandemic, most (44.2%) do not perform SARS‐CoV‐2 PCR screening first. A little more than a quarter did so for patients with signs of illness, and 20.3% did it for all patients.

Intervals between face‐to‐face follow‐up visits were prolonged by 71.6% of dermatologists, who reported that this harmed patients psychologically, interfered with drug compliance, and worsened psoriasis manifestations.

More than half of providers said their patients discontinued treatment without checking with them, mainly for financial reasons, fear of receiving medications, and/or lack of accessibility to treatment.

About 60% of physicians said they used telemedicine during this time.

More than 75% of responders either agreed or strongly agreed that COVID‐19 had a negative impact on psoriasis care.

Reference

El-Komy MHM, Adbelnaby A, El-Kalioby M. How does COVID‐19 impact psoriasis practice, prescription patterns, and healthcare delivery for psoriasis patients? A cross‐sectional survey study. J Cosmet Dermatol. Published online April 3, 2021. doi:10.1111/jocd.14104