Lack of 'appropriately assessed' patient-reported outcomes in randomized controlled trials assessing the effectiveness of interventions for rosacea
Department of Dermatology, B1-Q, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, the Netherlands U.K. Cochrane Centre (Bahrain Branch), College of Medicine, AMA International University of Bahrain, Awali, Bahrain E-mail: .British Journal of Dermatology (Impact Factor: 4.28). 07/2012; 168(2). DOI: 10.1111/j.1365-2133.2012.11148.x
Rosacea is a chronic skin disease and psychological problems are fairly common in people affected by rosacea. The persistent red pimply rash on the face can be a source of embarrassment, anxiety and low self-esteem, may instil a lack of confidence and may even lead to depression or body dysmorphic disorder. Rosacea can also have a significant negative impact on health-related quality of life (HRQoL).We have documented the patient-reported outcomes (PRO) used in clinical trials identified in the Cochrane Review on the effectiveness of interventions for rosacea published in the Cochrane Library March 2011 and reported their measurement properties.(1) Here we discuss the results.
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ABSTRACT: Papulopustular rosacea is a stage of rosacea in which papulopustules appear on the nose and cheeks, more rarely on the forehead and chin, and exceptionally on the neck and other body areas, such as the bare skull or the back. This chapter briefly discusses incidence/prevalence and etiology/risk of the papulopustular rosacea. Typically, rosacea is a multistage disease. The stages are the flushing stage, or transitory congestive redness; the erythrosis stage, of persistent telangiectatic redness; the papulopustular stage; and the phyma stage. The chapter also discusses the effects of systemic treatments including tetracycline, doxycycline, ampicillin, clarithromycin, azithromycin, metronidazole, isotretinoin and octreotide. In addition, it discusses the effects of topical drugs such as permethrin and calcineurin inhibitors and the effects of laser and/or light-based treatments. Topical drugs are less likely to cause systemic adverse effects than systemically administered drugs, and compliance may be better. © 2003 BMJ Publishing Group, 2008, 2014 by John Wiley & Sons, Ltd.
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ABSTRACT: Background: Rosacea is a common problem that is underdiagnosed; if left untreated can result in physical disfigurement and emotional distress. Objective: We reviewed the current literature to determine the degree of psychosocial impact of rosacea and the importance of treatment. We also reviewed the current treatment options. Methods: A search of the MEDLINE, EMBASE, and psycINFO databases from 1946 to present was performed to identify previous articles regarding the psychosocial and quality-of-life (QoL) impact of rosacea. Results: A total of 17 studies were found that focused on the following areas: impact of disease on QoL, improvement of QoL with treatment, and willingness to pay. Limitations: Reviewed articles used different measurement systems to quantify impact on QoL making comparisons between studies difficult to interpret. Conclusion: Patients with rosacea have higher incidences of embarrassment, social anxiety, depression, and decreased QoL compared with the rest of the population. Adequate treatment of symptoms results in improvement of QoL in patients with rosacea. New options that target the facial erythema of rosacea may help mitigate the negative psychological impact of rosacea.
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ABSTRACT: The motivation for rosacea patients to seek and adhere to treatment is not well characterized. A patient journey is a map of the steps a patient takes as he/she progresses through different segments of the disease from diagnosis to management, including all the influences that can push him/her toward or away from certain decisions. We sought to examine each step of the rosacea patient journey to better understand key patient care boundaries faced by rosacea patients. A PubMed search of articles indexed for MEDLINE as well as a search of the National Rosacea Society Web site (http://www.rosacea.org) were conducted to identify articles and materials that quantitatively or qualitatively described rosacea patient experiences. Current literature pertaining to the rosacea patient journey was summarized. The rosacea patient journey is discussed. It is a useful tool to gain insight on patient experiences. Better understanding of the patient perspective by dermatologists can lead to better patient adherence to treatment and thus improved quality of life and satisfaction.