Psoriatic arthritis is a frequent manifestation of psoriasis, and has a high level of impact on physical functioning, work ability and quality of life. However, there have been few studies of the ...epidemiology, development of and risk factors for concomitant psoriatic arthritis in patients with psoriasis. This study analysed data from a German public health insurance database of > 2 million individuals. Factors influencing the development of psoriatic arthritis were determined by descriptively analysing comorbidities and Cox regression modelling. The prevalences of psoriasis and psoriatic arthritis were 2.63% and 0.29% in adults (18+ years) and, respectively, 0.30% and 0.01% in children (0–17 years). The proportion of adult patients with incident psoriasis who developed concomitant psoriatic arthritis within five years after diagnosis of psoriasis (mean 2.3 years) was 2.6%. Cardiovascular diseases are the most frequent comorbidity in patients with psoriasis with or without concomitant psoriatic arthritis. Depression and neurosis/stress disorder were identified as indicators for the development of psoriatic arthritis.
Epidemiology of urticaria in German children Staubach, Petra; Mann, Caroline; Peveling‐ Oberhag, Adriane ...
Journal der Deutschen Dermatologischen Gesellschaft,
July 2021, Letnik:
19, Številka:
7
Journal Article
Recenzirano
Odprti dostop
Summary
Background
To date, robust epidemiological metrics as well as data on comorbidity in pediatric urticaria are lacking. They form the basis for the design of efficient healthcare.
Methods
...Retrospective study to analyze epidemiological data in pediatric urticaria. The analysis is based on routine data of a health insurance company operating throughout Germany (DAK‐Gesundheit). Insured people under 18 years of age who received at least one confirmed outpatient or inpatient urticaria diagnosis according to the ICD‐10 classification in the years 2010 to 2015 were included in the analysis and compared to children without a corresponding diagnosis.
Results
Of 2.3 million insured individuals, 313,581 (13.5 %) were under 18 years of age (153,214 female). Urticaria was diagnosed in 1.7 % of the 313,581 patients. The prevalence of urticaria decreased with age from 3.0 % in the 0–3‐year age group to 1.0 % in the 14–18‐year age group. Boys and girls were almost equally affected in all age groups. Atopic diseases as comorbidity occurred more frequently in children with urticaria than in the control group (16.0 % vs. 8.0 %). Autoimmune diseases, mental health problems, and obesity also occurred more frequently in children with urticaria than in the control group.
Conclusions
The increased prevalence of specific comorbidities in children with urticaria suggests an increased need for screening. Multimodal treatment strategies need to be developed and interdisciplinary collaboration promoted.
Psoriasis (PS) is a chronic inflammatory skin disease, and it increasingly appears also in the elderly population. There is a rising interest in drug therapy for PS, especially for people receiving ...care in nursing homes (NH). Which PS-related drugs are prescribed in the time before nursing home admission (NHA), and to what extent does the supply of drugs change after NHA? Which specialties prescribe PS-related drugs? Statutory health insurance data were examined for people with PS, aged ≥ 65 years, who were newly admitted to a NH in the period 2011–2014 and observed for one year before and after NHA. Changes in prescription prevalence (pre-post comparison) were examined for significant differences. Prescriptions of PS-relevant drugs were measured by defined daily dose and stratified according to the prescribing specialist group. The analysis included 718 insured persons with PS (76.2% female, mean age 83.3 years). Systemic therapeutics played a minor role (pre: 2.6% vs. post: 2.1%) in drug therapy. Topical steroids had a high share of about 40% in the pre–post comparison. Overall, the proportion of people with PS who received treatment remained at a comparable level before and after NHA. A structured assessment of the skin is crucial, specifically in people with cognitive impairment.
ZusammenfassungHintergrund und ZielsetzungEs gibt nur wenige Studien zur Epidemiologie der Psoriasis und Psoriasis‐Arthritis in Deutschland. Ziel dieser Studie war es, diese Prävalenz anhand ...verschiedener Falldefinitionen zu schätzen.MethodenEs wurden Daten der Gesetzlichen Krankenversicherung (GKV) untersucht (2017 bis 2019). Die Prävalenz wurde anhand von drei verschiedenen Falldefinitionen analysiert und validiert: (1) mindestens eine stationäre oder ambulante Diagnose innerhalb eines Jahres (2) mindestens zwei ambulante Diagnosen innerhalb eines Jahres (3) zusätzlich innerhalb von drei Jahren.ErgebnisseDie administrative Prävalenz der Psoriasis inklusive Psoriasis‐Arthritis lag zwischen 1,90% und 2,51%. Bei allen Falldefinitionen nahm die Prävalenz mit dem Alter zu, wobei sie bei der Psoriasis ab einem Alter von 70 Jahren und bei der Psoriasis‐Arthritis ab einem Alter von 65 Jahren sank. Männer waren im höheren Alter häufiger betroffen (p <0,0001), während in der Altersgruppe der unter 20‐Jährigen mehr Mädchen betroffen waren (p = 0,04).SchlussfolgerungDie Psoriasis ist eine häufige Hauterkrankung in Deutschland. Die interne Diagnosenvalidierung hat gezeigt, dass in zukünftigen Studien mit GKV‐Routinedaten, je nach Fragestellung, die engen oder weiten Kriterien zur Identifizierung von Patienten mit Psoriasis verwendet werden sollten.
Zusammenfassung
Hintergrund und Zielsetzung
Es gibt nur wenige Studien zur Epidemiologie der Psoriasis und Psoriasis‐Arthritis in Deutschland. Ziel dieser Studie war es, diese Prävalenz anhand ...verschiedener Falldefinitionen zu schätzen.
Methoden
Es wurden Daten der Gesetzlichen Krankenversicherung (GKV) untersucht (2017 bis 2019). Die Prävalenz wurde anhand von drei verschiedenen Falldefinitionen analysiert und validiert:
(1)
mindestens eine stationäre oder ambulante Diagnose innerhalb eines Jahres
(2)
mindestens zwei ambulante Diagnosen innerhalb eines Jahres
(3)
zusätzlich innerhalb von drei Jahren.
Ergebnisse
Die administrative Prävalenz der Psoriasis inklusive Psoriasis‐Arthritis lag zwischen 1,90% und 2,51%. Bei allen Falldefinitionen nahm die Prävalenz mit dem Alter zu, wobei sie bei der Psoriasis ab einem Alter von 70 Jahren und bei der Psoriasis‐Arthritis ab einem Alter von 65 Jahren sank. Männer waren im höheren Alter häufiger betroffen (p <0,0001), während in der Altersgruppe der unter 20‐Jährigen mehr Mädchen betroffen waren (p = 0,04).
Schlussfolgerung
Die Psoriasis ist eine häufige Hauterkrankung in Deutschland. Die interne Diagnosenvalidierung hat gezeigt, dass in zukünftigen Studien mit GKV‐Routinedaten, je nach Fragestellung, die engen oder weiten Kriterien zur Identifizierung von Patienten mit Psoriasis verwendet werden sollten.
Zusammenfassung
Hintergrund und Zielsetzung
Es gibt nur wenige Studien zur Epidemiologie der Psoriasis und Psoriasis‐Arthritis in Deutschland. Ziel dieser Studie war es, diese Prävalenz anhand ...verschiedener Falldefinitionen zu schätzen.
Methoden
Es wurden Daten der Gesetzlichen Krankenversicherung (GKV) untersucht (2017 bis 2019). Die Prävalenz wurde anhand von drei verschiedenen Falldefinitionen analysiert und validiert: (1) mindestens eine stationäre oder ambulante Diagnose innerhalb eines Jahres (2) mindestens zwei ambulante Diagnosen innerhalb eines Jahres (3) zusätzlich innerhalb von drei Jahren.
Ergebnisse
Die administrative Prävalenz der Psoriasis inklusive Psoriasis‐Arthritis lag zwischen 1,90% und 2,51%. Bei allen Falldefinitionen nahm die Prävalenz mit dem Alter zu, wobei sie bei der Psoriasis ab einem Alter von 70 Jahren und bei der Psoriasis‐Arthritis ab einem Alter von 65 Jahren sank. Männer waren im höheren Alter häufiger betroffen (p <0,0001), während in der Altersgruppe der unter 20‐Jährigen mehr Mädchen betroffen waren (p = 0,04).
Schlussfolgerung
Die Psoriasis ist eine häufige Hauterkrankung in Deutschland. Die interne Diagnosenvalidierung hat gezeigt, dass in zukünftigen Studien mit GKV‐Routinedaten, je nach Fragestellung, die engen oder weiten Kriterien zur Identifizierung von Patienten mit Psoriasis verwendet werden sollten.
Summary
Background and Objectives
Few studies are available on the epidemiology of psoriasis and psoriatic arthritis in Germany. The aim of this study was to estimate this prevalence based on ...different case definitions.
Methods
Statutory health insurance (SHI) data were examined (2017 to 2019). Prevalence was analyzed and validated using three different case definitions: (1) At least one inpatient or outpatient diagnosis within one year, (2) additionally at least two outpatient diagnoses within one year, (3) additionally within three years.
Results
The administrative prevalence of psoriasis including psoriatic arthritis ranged from 1.90% to 2.51%. For all case definitions, the prevalence increased with age, decreasing from the age of 70 with psoriasis and from the age of 65 with psoriatic arthritis. Males were more likely to be affected at an older age (p <0.0001), while in the under‐20 age group, more girls were affected (p = 0.04).
Conclusions
Psoriasis is a common skin disease in Germany. The internal diagnoses validation showed that in future studies with claims data, the narrow and broad criteria should be used to identify patients with psoriasis, depending on the research question.
Patients with peripheral artery disease (PAD) have an increased risk of lower limb amputation. Given the international wide variance in major amputations, the high mortality rates and follow up costs ...as well as the significantly reduced quality of life of patients with amputations, vascular diagnostics and vascular surgery treatments are of great importance for lower limb preservation in patients with PAD. This study examines these guideline based procedures in patients before a first lower limb amputation and PAD.
This was a retrospective longitudinal study. Data from a large German statutory health insurance scheme were examined on patients with first amputation of lower extremities and PAD between 2013 and 2015 (incidence). Pre-defined vascular diagnostic and vascular surgical procedures were considered, as specified by guidelines within inpatient and outpatient care in a defined time before lower limb amputation.
The overall estimated incidence of lower extremity amputations in the total population was 0.12% from 2013 to 2015. Of these, 51.7% had PAD; 81.8% of patients received at least one vascular diagnostic measure and 61.0% a vascular surgery procedure before the lower extremity amputation. There were only minor variations in the use of diagnostic or surgical treatments between patients with major and minor amputation. In total, 63.9% of patients had vascular surgery before the incident major amputation compared with 60.0% of patients with a minor amputation. Noticeable regional differences were found ranging from 91% (Berlin) to 67% (Bremen) regarding diagnostic procedures provided before amputation, and from 83% (Hamburg) to 55% (Saxony-Anhalt) regarding vascular surgery before amputations.
Of patients with PAD, 18.2% did not receive a vascular diagnostic examination before amputation as specified in the guidelines, which reflects an underuse of health services. In one third of patients who did not receive vascular surgery, major amputation probably could have been avoided.
Summary
Background
There are regional differences in skin cancer screening uptake in Germany. So far, it is unclear whether a high uptake of screening services leads to a reduction in mortality. This ...article presents study results on the investigation of spatiotemporal associations between skin cancer screening and mortality. The methods used are discussed regarding their suitability.
Material and methods
The basis is ambulatory claims data on the utilization of early skin cancer detection as well as data on skin cancer mortality from the cause‐of‐death statistics of the years 2011–2015 at county level in Germany. In addition to a descriptive evaluation, spatiotemporal cluster analyses and regression models were used to investigate the relationship between the uptake of early detection and mortality. In addition to age, adjustments were also made for other selected socio‐economic and socio‐graphical variables.
Results
The descriptive results show striking spatial patterns of skin cancer screening and mortality. Cluster analyses identified regions with significantly higher and lower cases of early detection and skin cancer mortality. The spatiotemporal regression analyses show no clear association. Only early detection by a dermatologist, adjusted for age, shows an association with mortality.
Conclusions
No clear association between early skin cancer detection and mortality can be derived from the results. However, the study design used with a spatiotemporal cluster and regression analysis has shown that these methods allow in‐depth statements about the relationship between early skin cancer detection and mortality.
Background and objective
Demographic change confers significance to healthcare management of chronic diseases like psoriasis. There are few studies on the care of older people with psoriasis, ...particularly for the nursing home setting. It was investigated whether the number of psoriasis patients with specialist contact changes before vs. after nursing home admission.
Material and methods
We analyzed claims data of a German health insurance company including a cohort of newly admitted nursing home residents aged 65 years and older between 2011 and 2014, who received a diagnosis of psoriasis 1 year before nursing home admission. Outpatient care was compared between the years before vs. after nursing home admission. We conducted a multivariate regression analysis for identifying predictors for dermatological care.
Results
The study cohort included 718 insured persons (Ø83 years). Proportion of patients who had contact to a dermatologist significantly decreased after nursing home entry (44.6% before vs. 40.1% after nursing home entry). Strongest predictors for dermatological care after entry were a previously existing dermatological contact (odds ratio, OR 3.87, 95% confidence interval, CI 2.70–5.54) and prescription for topical steroids (OR 1.61, 95% CI 1.14–2.28).
Conclusion
The analysis of health insurance data showed a pertinent decrease in the use of outpatient dermatological care after institutionalization. The evaluation of the adequacy of care is difficult due to the used database without clinical information. As long as no further investigations of this vulnerable patient group are available, the care of psoriasis patients of old age should be closely monitored. Dermatological knowledge of the skin in old age is an essential prerequisite for this.
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