Limited evidence of the effects of patient education and self-management interventions in psoriasis patients: a systematic review

Marie Hamilton Larsen; Kåre Birger Hagen; Anne-Lene Krogstad; Eline Aas; Astrid Klopstad Wahl

doi:10.1016/j.pec.2013.10.005

Limited evidence of the effects of patient education and self-management interventions in psoriasis patients: a systematic review

Patient Educ Couns. 2014 Feb;94(2):158-69. doi: 10.1016/j.pec.2013.10.005. Epub 2013 Oct 14.

Authors

Marie Hamilton Larsen¹, Kåre Birger Hagen², Anne-Lene Krogstad³, Eline Aas⁴, Astrid Klopstad Wahl⁵

Affiliations

¹ Medical Faculty, Department of Health Sciences, Institute of Health and Society, University of Oslo, Norway; Section for Climate Therapy, Integration and International Collaboration, Oslo University Hospital, Norway. Electronic address: m.h.larsen@medisin.uio.no.
² Medical Faculty, Department of Health Sciences, Institute of Health and Society, University of Oslo, Norway; National Resource Centre for Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Norway. Electronic address: k.b.hagen@medisin.uio.no.
³ Section for Climate Therapy, Integration and International Collaboration, Oslo University Hospital, Norway; The Department of Dermatology, Oslo University Hospital, Norway. Electronic address: a.l.krogstad@ous-hf.no.
⁴ Medical Faculty, Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Norway. Electronic address: eline.aas@medisin.uio.no.
⁵ Medical Faculty, Department of Health Sciences, Institute of Health and Society, University of Oslo, Norway. Electronic address: a.k.wahl@medisin.uio.no.

PMID: 24184041
DOI: 10.1016/j.pec.2013.10.005

Abstract

Objective: To describe the contents of educational and self-management programmes for patients with psoriasis, and to evaluate their effects.

Methods: A systematic review of randomized controlled trials (RCTs), quasi-randomized trials and controlled clinical trials identified by a systematic literature search. Risk of bias was assessed by two independent reviewers and interventional effects were summarized descriptively and by meta-analysis.

Results: Nine studies were included, which ranged from single brief interventions to long complex multidisciplinary programmes. Four RCTs with adequate sequence allocation were included to analyze interventional effects. One RCT compared two different educational programmes and found no differences between groups. The results of three trials that focused on combinations of education and self-management were heterogeneous. One RCT based on a 12-week comprehensive programme reported statistically significant effects (p<0.05) on disease severity and health-related quality of life. Two RCTs with less comprehensive programmes reported no effects on HRQoL.

Conclusion: This review showed that little evidence is available to support the effects of educational and self-management interventions in patients with psoriasis that are studied in RCTs. There is a significant lack of focused self-management and, compared with other chronic conditions, there appear to be few effective disease-specific tailored educational programmes for psoriasis.

Keywords: Patient education; Psoriasis; Review; Self-management.

Publication types

Review
Systematic Review

MeSH terms

Humans
Patient Education as Topic*
Psoriasis / therapy*
Quality of Life
Randomized Controlled Trials as Topic
Self Care*