Feasibility and Utility of the Psoriasis Symptom Inventory (PSI) in Clinical Care Settings: A Study from the International Psoriasis Council

Am J Clin Dermatol. 2019 Oct;20(5):699-709. doi: 10.1007/s40257-019-00458-2.

Abstract

Background: The Psoriasis Symptom Inventory (PSI) is a patient-reported outcome measure designed to assess psoriasis signs and symptoms.

Objectives: The aim was to assess the usefulness of the PSI in enhancing patient care in the clinical setting.

Methods: Eight dermatology clinics in six countries enrolled adults representing the full spectrum of psoriasis severity who regularly received care at the clinic. Patients were administered the eight-item PSI (score range 0-32; higher scores indicate greater severity) while waiting for the physician; the physician conducted a static physician global assessment (sPGA) and estimated psoriasis-affected body surface area (BSA) at the same visit. Physicians completed a brief questionnaire after each patient visit, and were interviewed about the PSI after all patients were seen.

Results: The clinics enrolled 278 patients; mean [standard deviation (SD)] psoriasis-affected BSA was 7.6% (11.4). Based on BSA, 47.8% had mild psoriasis, 29.1% had moderate psoriasis, and 23.0% had severe psoriasis. Based on sPGA, 18.7% were clear/almost clear, 67.3% were mild/moderate, and 14.0% were severe/very severe. The mean (SD) PSI total score was 12.2 (8.3). Physicians spent a mean (SD) 4.9 (4.8) min discussing PSI findings with their patients (range 0-20 min). Key benefits of PSI discussions included the following: new information regarding symptom location and severity for physicians; prompting of quality-of-life discussions; better understanding of patient treatment priorities; change in treatment regimens to target specific symptoms or areas; and improvement of patient-physician relationship.

Conclusions: The PSI was useful for treated and untreated patients to enhance patient-physician communication, and influenced treatment decisions.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Clinical Decision-Making / methods
  • Communication
  • Cross-Sectional Studies
  • Feasibility Studies
  • Female
  • Humans
  • International Cooperation
  • Male
  • Middle Aged
  • Patient Reported Outcome Measures*
  • Physician-Patient Relations
  • Psoriasis / diagnosis*
  • Psoriasis / therapy
  • Quality of Life
  • Severity of Illness Index*
  • Surveys and Questionnaires
  • Treatment Outcome
  • Young Adult