Freedom from disease in psoriasis: a Delphi consensus definition by patients, nurses and physicians

Area of Science:

• Dermatology and patient-reported outcomes research.
• Consensus methodology in healthcare.

Background:

• Current plaque psoriasis assessments rely on physician-reported outcomes and quality of life (QoL) measures.
• Patients with psoriasis may define treatment success differently than healthcare providers.

Purpose of the Study:

• To establish a unified consensus definition of "freedom from disease" in psoriasis.
• To incorporate European stakeholder perspectives, including patients, dermatologists, and nurses.

Main Methods:

• Utilized a modified Delphi consensus methodology involving a 15-member Facilitating Consensus Panel and a larger Voting Consensus Panel.
• The process included extensive patient involvement throughout, with two voting rounds and a final consensus meeting.
• The Facilitating Panel identified key disease domains, which were then prioritized by the Voting Consensus Panel.

Main Results:

• The consensus definition of "freedom from disease" is multifaceted, incorporating five key domains: management of clinical symptoms, psychosocial elements, quality of life and well-being, treatment, and healthcare team support.
• Voting respondents emphasized the importance of "normality of living," symptom control, and a trusting patient-healthcare professional relationship.
• "Freedom from disease" was agreed to mean that all identified aspects are comprehensively addressed.

Conclusions:

• "Freedom from disease" in psoriasis is a complex, multidimensional concept.
• The consensus highlights five core domains crucial for defining successful psoriasis treatment outcomes.
• Incorporating this patient-centered perspective enhances the understanding of treatment intervention effectiveness for individuals with psoriasis.