TY - JOUR T1 - General practice recommendations for the topical treatment of psoriasis: a modified-Delphi approach JF - BJGP Open JO - BJGP Open DO - 10.3399/bjgpopen20X101108 SP - bjgpopen20X101108 AU - Diamant Thaçi AU - Pablo de la Cueva AU - Andrew E Pink AU - Ahmad Jalili AU - Siegfried Segaert AU - Kasper F Hjuler AU - Piergiacomo Calzavara-Pinton Y1 - 2020/11/11 UR - http://bjgpopen.org/content/early/2020/11/09/bjgpopen20X101108.abstract N2 - Background Although GPs are usually the first port of call for patients with psoriasis, there is a lack of consistent and up-to-date clinical recommendations for interventions for patients with mild-to-moderate disease.Aim To provide practical recommendations for GPs to optimise psoriasis treatment with topical therapies in four key areas: patient identification; treatment decision making with topical theory; topical treatment outcomes; and optimising patient adherence.Design & setting A consensus-seeking programme (modified-Delphi approach) was undertaken to assess the literature and develop recommendations for GPs, based on evidence and expert opinion.Method Three dermatologists compiled 47 questions that were subsequently ranked and refined according to clinical relevance or importance using an online survey. Thereafter, 19 dermatologists from different European countries developed statements and clinical recommendations for the top seven ranked topical treatment and GP-relevant questions based on literature research and clinical experience. The final recommendations were based on 100% agreement among a final panel of seven experts.Results The clinical effectiveness, fast onset of action, tolerability, cosmetic acceptability, and practicability of topical therapy, in addition to good physician—patient communication, are important for optimising patient adherence and maximising efficacy. Topical treatments combining corticosteroids and vitamin D analogues (administered as fixed combination) are well-established first-line treatments in mild-to-moderate psoriasis.Conclusion Simple but detailed practical guidance is provided, which is formed from evidence and expert clinical recommendations, to assist GPs with the optimal use of topical agents based on efficacy, tolerability, disease severity, site of psoriasis, patient lifestyle and preferences, and intended duration of treatment. ER -