Psoriasis is a chronic inflammatory skin disease that significantly impacts patients’ quality of life. Although biological therapies are effective, they are associated with high costs and potential side effects, necessitating strategies for dose reduction. Pharmacological conditioning, using placebo mechanisms through associative learning, presents a promising approach to maintain therapeutic efficacy with lower doses of medication.

The single-centre, randomised controlled trial aims to investigate pharmacological conditioning with secukinumab in patients with moderate-to-severe psoriasis (N=168). Participants will be randomly allocated to a treatment-as-usual group or one of two experimental groups receiving partial or continuous reinforcement schedules with reduced secukinumab doses combined with a distinctive gustatory stimulus. Primary outcomes include changes in itch intensity, skin-related quality of life and objective disease severity. Secondary outcomes encompass psychological variables, side effects and biological markers. Results may contribute to optimised long-term psoriasis management, reducing medication burden while maintaining treatment efficacy.

The study protocol was approved by the ethics committee of the University Hospital Essen (19–8636 BO) on 20 November 2023. Written informed consent will be obtained from all participants. Participant confidentiality will be ensured through pseudonymised data handling and secure storage. The results will be disseminated through peer-reviewed publications.

DRKS00034977.

Prehospital notification by emergency medical services (EMS) can activate hospital resources before the patient arrives, which has been shown to improve in-hospital care for stroke patients. Optimising prehospital and handover processes in stroke care requires considering end-user perspectives to enhance acceptance and effectiveness of the developed solutions. The aim of this study was to identify current barriers in the preclinical-clinical phase of stroke care.

Within the investigator-initiated CAEHR project (CArdiovascular diseases—Enhancing Healthcare through cross-sectoral Routine data integration), an interface for transferring data from the electronic prenotification system to the hospital information system is implemented. A mixed-methods approach with semi-structured interviews as well as a cross-sectional online survey was used to gather feedback from healthcare professionals at a single stroke centre in Germany as well as from the participating EMS personnel. Data collection for the interviews was conducted between January and August 2023 and for the online survey between May and September 2023.

Interviews were conducted with 10 healthcare professionals, including seven from the neurological clinic and three from EMS. Additionally, 39 EMS employees took part in a cross-sectional online survey.

Challenges identified were educational and training aspects affecting preclinical processes and patient handover procedures, along with the opportunity for establishing more uniform protocols. Participants emphasised the importance of detailed patient information. Electronic prenotification was seen as an important step regarding structured information transmission, reducing the risk of information loss in stroke care.

The study highlights the importance of addressing organisational processes in addition to technical interfaces for implementing effective stroke care processes.

German Clinical Trials Register, DRKS00029103.