Management practice, and quality of life and its associated factors among ambulatory psoriatic patients attending Dermatological Center in Addis Ababa, Ethiopia

Abstract Background: Psoriasis is a chronic inflammatory disease characterized by keratinocyte hyperproliferation and aberrant differentiation with great negative impact on patients’ quality of life (QoL). This study aimed at assessing management practice, and quality of life (QoL) and its associated factors among ambulatory psoriatic patients visiting All Africa Leprosy, Tuberculosis and Rehabilitation Training (ALERT) Center in Addis Ababa, Ethiopia.Materials and methods: A cross sectional study was conducted among 207 patients with psoriasis attending the dermatology clinic of ALERT Center in Addis Ababa, Ethiopia. Data were collected using structured questionnaire and patients’ chart review. Dermatology Life Quality Index (DLQI) was used to measure patients’ QoL. Data was analyzed entered and analyzed using Statistical Package for Social Sciences (SPSS®) version 25. Descriptive statistics like frequency, percent, mean and standard deviation were used to summarize patients’ characteristics while binary logistic regression was utilized to identify predictors of quality of life. Results: Among 207 study participants, 122(58.9%) were females. The mean age of the study population was 37.92(SD=14.86) years (ranging from 16 to 68 years). The mean age at which diagnosis of psoriasis made was 32.0(SD=13.7) years ranging from 10 to 62 years. The duration of the disease in 112(54.1%) patients were more than or equal to 5 years. Among study participants, the majority of them, 145(70.0%) had plaque psoriasis followed by sebopsoriasis, 24(11.6%). The majority of plaque psoriasis (80%) cases were managed by topical corticosteroids with or without salicylic acid or coal tar and only 21(14.5%) treated by methotrexate alone. Other forms of psoriasis were treated by only topical corticosteroids with or without salicylic acid. The mean DLQI was 6.25 corresponding to a moderate effect. Symptoms and feelings were the most affected domains of QoL. Factors associated with poor QoL were female gender [AOR=0.17 (95%CI: 0.06, 0.48)], low, above average and high family income ([AOR=0.12(95% CI: 0.02, 0.56)], [AOR=0.06(95% CI:0.01, 0.32)], and [AOR=0.03 (95% CI: 0.01, 0.22)]) respectively and primary education level [AOR=0.14 (95% CI: 0.03, 0.64)] while being on systemic therapy [AOR=4.26 (CI: 1.18, 15.35)] was predictor of better QoL.Conclusion: Topical corticosteroids were the mainstay of psoriasis treatment in our study. The mean DLQI was 6.25, corresponding to a moderate effect on QoL. Study participants with female gender, primary education level, and low, above average, and high monthly family income were considered to have worse QoL whereas receiving systemic therapy significantly associated with better QoL. Hence, future interventions targeting improving QoL and widening treatment options for psoriasis deemed to be necessary.