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• W2099381191 abstract "To the Editor: Vitiligo often has a negative effect on quality of life and several treatments are available; however, patient satisfaction with treatment is a seldom used outcome measure in trials, with a recent systematic review reporting only 7% of studies measuring patient satisfaction in the past 40 years.1Alikhan A. Felsten L.M. Daly M. et al.Vitiligo: a comprehensive overview, Part I. Introduction, epidemiology, quality of life, diagnosis, differential diagnosis, associations, histopathology, etiology, and work-up.J Am Acad Dermatol. 2011; 65: 473-491Abstract Full Text Full Text PDF PubMed Scopus (415) Google Scholar, 2Teovska Mitrevska N. Eleftheriadou V. Guarneri F. Quality of life in vitiligo patients.Dermatol Ther. 2012; 25: S28-S31Crossref PubMed Scopus (19) Google Scholar, 3Eleftheriadou V. Thomas K.S. Whitton M.E. Batchelor J.M. Ravenscroft J.C. Which outcomes should we measure in vitiligo? Results of a systematic review and a survey among patients and clinicians on outcomes in vitiligo trials.Br J Dermatol. 2012; 167: 804-884Crossref PubMed Scopus (62) Google Scholar The goal of this cross-sectional study was to determine overall patient satisfaction with commonly used treatments for vitiligo.All patients enrolled in the Dallas Vitiligo Registry (DVR) at UT Southwestern Medical Center, Dallas, Texas, from April 2013 to August 2014 were surveyed regarding satisfaction with treatment. The DVR is approved by a local institutional review board and all patients gave informed consent. Treatments included narrowband ultraviolet B (NBUVB) phototherapy, topical corticosteroids, topical tacrolimus, and 1.5-mm punch grafts. Most patients were on combination therapy with at least 2 of the aforementioned treatments at the same time. All had been exposed to each therapy alone for at least 1 month. Patients were asked to assess overall satisfaction with each treatment they had received. Taking into account time commitment, cost, distance traveled, repigmentation achieved, and associated side effects, each patient marked a visual analog scale (VAS) in which 0 indicated extreme dissatisfaction and 100 indicated extreme satisfaction.Phototherapy had the highest satisfaction score of 78, while topical tacrolimus had the lowest score of 41 (Table I). A one-way analysis of variance showed a statistically significant difference between the means (P < .001). A multiple comparison analysis using a Tamhane post hoc test to determine which pairs of the group were significantly different showed a significant difference between phototherapy and topical corticosteroids (P < .001) as well as between phototherapy and topical tacrolimus (P < .001).Table IVisual analog scores for patient satisfaction with vitiligo treatmentsTreatmentNMean VAS score95% Confidence intervalNBUVB phototherapy787873-83Topical corticosteroids825246-59Topical 0.1% tacrolimus514132-50Skin grafting206448-80 Open table in a new tab Although the size of the study was too small to compare topical therapies and grafting, it is clear that NBUVB phototherapy is the most satisfactory treatment to patients. Patients were not queried directly regarding the reasons for their choices, although many stated that NBUVB had superior efficacy in repigmenting their vitiligo lesions compared to topical therapies.A limitation of the study is that most of the patients were on combination therapy and all of the potential treatments were not an option in every patient, making comparison difficult. Another limitation is the lack of uniform duration of treatment for all patients and inclusion of all types of vitiligo. Additionally, 1 month of treatment may be too short a duration of treatment to expect a response. Future studies should control for these factors and compare satisfaction with individual treatments in a larger number of patients used over a longer period of time. Satisfaction with treatment should also be compared to disease severity.Although satisfaction with treatment is not often measured, there is a recent emphasis for more patient-centered approaches to the practice of medicine.4Capko J. The patient-centered movement.J Med Pract Manage. 2014; 29: 238-242PubMed Google Scholar Patient satisfaction can play an integral role in patient outcome measures and quality of care. As new payment models focusing on patient satisfaction to determine reimbursement rates for physicians and hospitals are developed, these studies will become even more important. To the Editor: Vitiligo often has a negative effect on quality of life and several treatments are available; however, patient satisfaction with treatment is a seldom used outcome measure in trials, with a recent systematic review reporting only 7% of studies measuring patient satisfaction in the past 40 years.1Alikhan A. Felsten L.M. Daly M. et al.Vitiligo: a comprehensive overview, Part I. Introduction, epidemiology, quality of life, diagnosis, differential diagnosis, associations, histopathology, etiology, and work-up.J Am Acad Dermatol. 2011; 65: 473-491Abstract Full Text Full Text PDF PubMed Scopus (415) Google Scholar, 2Teovska Mitrevska N. Eleftheriadou V. Guarneri F. Quality of life in vitiligo patients.Dermatol Ther. 2012; 25: S28-S31Crossref PubMed Scopus (19) Google Scholar, 3Eleftheriadou V. Thomas K.S. Whitton M.E. Batchelor J.M. Ravenscroft J.C. Which outcomes should we measure in vitiligo? Results of a systematic review and a survey among patients and clinicians on outcomes in vitiligo trials.Br J Dermatol. 2012; 167: 804-884Crossref PubMed Scopus (62) Google Scholar The goal of this cross-sectional study was to determine overall patient satisfaction with commonly used treatments for vitiligo. All patients enrolled in the Dallas Vitiligo Registry (DVR) at UT Southwestern Medical Center, Dallas, Texas, from April 2013 to August 2014 were surveyed regarding satisfaction with treatment. The DVR is approved by a local institutional review board and all patients gave informed consent. Treatments included narrowband ultraviolet B (NBUVB) phototherapy, topical corticosteroids, topical tacrolimus, and 1.5-mm punch grafts. Most patients were on combination therapy with at least 2 of the aforementioned treatments at the same time. All had been exposed to each therapy alone for at least 1 month. Patients were asked to assess overall satisfaction with each treatment they had received. Taking into account time commitment, cost, distance traveled, repigmentation achieved, and associated side effects, each patient marked a visual analog scale (VAS) in which 0 indicated extreme dissatisfaction and 100 indicated extreme satisfaction. Phototherapy had the highest satisfaction score of 78, while topical tacrolimus had the lowest score of 41 (Table I). A one-way analysis of variance showed a statistically significant difference between the means (P < .001). A multiple comparison analysis using a Tamhane post hoc test to determine which pairs of the group were significantly different showed a significant difference between phototherapy and topical corticosteroids (P < .001) as well as between phototherapy and topical tacrolimus (P < .001). Although the size of the study was too small to compare topical therapies and grafting, it is clear that NBUVB phototherapy is the most satisfactory treatment to patients. Patients were not queried directly regarding the reasons for their choices, although many stated that NBUVB had superior efficacy in repigmenting their vitiligo lesions compared to topical therapies. A limitation of the study is that most of the patients were on combination therapy and all of the potential treatments were not an option in every patient, making comparison difficult. Another limitation is the lack of uniform duration of treatment for all patients and inclusion of all types of vitiligo. Additionally, 1 month of treatment may be too short a duration of treatment to expect a response. Future studies should control for these factors and compare satisfaction with individual treatments in a larger number of patients used over a longer period of time. Satisfaction with treatment should also be compared to disease severity. Although satisfaction with treatment is not often measured, there is a recent emphasis for more patient-centered approaches to the practice of medicine.4Capko J. The patient-centered movement.J Med Pract Manage. 2014; 29: 238-242PubMed Google Scholar Patient satisfaction can play an integral role in patient outcome measures and quality of care. As new payment models focusing on patient satisfaction to determine reimbursement rates for physicians and hospitals are developed, these studies will become even more important. Study data were collected and managed using REDCap electronic data capture tools hosted at the University of Texas Southwestern Medical Center. REDCap (Research Electronic Data Capture) is a secure, web-based application designed to support data capture for research studies, providing (1) an intuitive interface for validated data entry, (2) audit trails for tracking data manipulation and export procedures, (3) automated export procedures for seamless data downloads to common statistical packages, and (4) procedures for importing data from external sources. (Paul A. Harris, Robert Taylor, Robert Thielke, et al. Research electronic data capture (REDCap)−A metadata-driven methodology and workflow process for providing translational research informatics support, J Biomed Inform. 2009;42:377-381.)" @default.
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• W2099381191 title "Patient satisfaction with different treatment modalities for vitiligo" @default.
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