Home versus outpatient uvb phototheray
Type:Uv phototherapy Time:2016-09-06 11:40:15Published on May 7, 2009 at 7:51 PM ¡¤ No Comment
For
patients with psoriasis, treatment with ultraviolet B (UVB) at home is
as effective and as safe as conventional hospital based phototherapy,
concludes a study published on bmj.com today.
Patients also find home UVB therapy less of a burden and are more satisfied with treatment, the findings show.
Psoriasis
is a common, chronic inflammatory skin condition that causes
significant disability to sufferers and their families. UVB treatment is
safe and effective, but few patients in the UK ever receive it because
of limited availability and time constraints (a course of treatment
typically involves attending hospital three times each week for eight to
10 weeks).
Furthermore, most dermatologists
believe that home phototherapy is inferior to hospital treatment and
that it carries more risks, despite there being no evidence to support
this.
So a team of researchers in the
Netherlands compared the safety and effectiveness of home phototherapy
with standard hospital based phototherapy. They identified 196 patients
with psoriasis from 14 hospital dermatology departments. Patients were
randomised to receive either home UVB phototherapy or hospital based
phototherapy.
The home group used a
phototherapy unit in their homes, while the hospital group received the
treatment at their local hospital. Both treatment at home and at the
hospital were applied according to standard routine practice. Disease
severity after treatment was measured using recognised scoring scales.
Side effects and total cumulative dose of UVB were also recorded.
The
results show that home phototherapy is equally safe and equally
effective as outpatient phototherapy, both clinically and in terms of
quality of life. Patients treated at home reported a significantly lower
burden of treatment and greater satisfaction with treatment.
And the majority of patients said they would prefer home UVB therapy over hospital based therapy in the future.
This
study clearly shows that home UVB phototherapy is a good alternative
that should be considered instead of the standard outpatient UVB
phototherapy for patients with psoriasis, say the authors. They suggest
that current guidelines should be updated to reflect this.
This
study highlights an important gap in the provision of treatment for
patients with psoriasis and it is timely to reassess conventional
treatments such as UVB, writes Professor Alex Anstey from the Royal
Gwent Hospital, in an accompanying editorial.
To
make home based phototherapy become a reality, an economic assessment
of different UVB service models is needed, he says. Meanwhile,
healthcare commissioners should work with local dermatologists to
improve access to UVB phototherapy services.
Experience
in Germany, the US, the Netherlands, and Scotland confirms that it
would be feasible and practical to implement home based UVB
phototherapy, he concludes
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