[Dermatological care of elderly people with psoriasis before and after entering a nursing home : A qualitative analysis from the perspective of medical providers]. / Dermatologische Versorgung von älteren Menschen mit Psoriasis vor und nach Eintritt in ein Pflegeheim : Eine qualitative Analyse aus Sicht von medizinischen Versorgern.

BACKGROUND: Demographic changes are causing a rapid increase in the number of people over 65 years of age. This is associated with an increase in the number of multimorbid patients in need of care. Nationally as well as internationally, there is little information on the treatment of psoriasis patients in the nursing home setting and on the question of how this is influenced by entry into a nursing home. OBJECTIVE: The aim was to discuss the results of previous routine data analyses on the treatment of psoriasis patients in nursing homes with medical providers (dermatologists, general practitioners, nursing service managers, and nursing staff) on the basis of interviews and focus groups, to identify difficulties in the treatment and finally to derive recommendations for action regarding sustainable gerontodermatological treatment. MATERIALS AND METHODS: Qualitative guideline-based interviews and focus groups with dermatologists (n = 5), general practitioners (GPs, n = 7), nurses (n = 7), and care managers (n = 2) were conducted. The data were evaluated by content analysis. RESULTS: The analyses resulted in 344 statements, which could be categorized into 14 main topics. The results show that there is a need for improvement in the quality of care for people with skin diseases, especially psoriasis, in nursing homes. This is evident at both the medical and nursing levels. According to the providers (N = 21), this can be addressed in particular through increased remote consultations (telemedicine), dermatological training for GPs and nurses, and closer cooperation between the individual disciplines. CONCLUSION: Remote consultations, but also a specific guideline on the "skin of the ageing person" can be useful to improve the dermatological care situation in nursing homes and thus increase the well-being of those affected.

Low long-term efficacy and tolerability of add-on rufinamide in patients with Dravet syndrome.

In this retrospective European multicenter study we evaluated the efficacy and tolerability of rufinamide in patients with Dravet syndrome and refractory seizures. Twenty patients were included; in 16 patients a SCN1A mutation was detected. The responder rate after 6 months was 20%, and after 34 months, 5%. The retention rate was 45% after 6 months and 5% after 34 months. Rufinamide treatment was stopped because of aggravation of seizures (30%), no effect (45%), and side effects (10%). The efficacy and long-term retention rate were low in our patients with Dravet syndrome and refractory seizures, far lower than in patients with Lennox-Gastaut syndrome; one-third of our patients experienced seizure aggravation. Therefore, rufinamide does not seem to be a suitable option for long-term treatment in patients with Dravet syndrome.