A Report of 4 Years of Experience of a Multidisciplinary Unit of Psoriasis and Psoriatic Arthritis

Luelmo, Jesús; Gratacós, Jordi; Martínez-Losa, Mireia Moreno; Ribera, M.; Romaní, Jorge; Calvet, J; Leal, Lorena; Larrosa, M.

doi:10.1016/j.reumae.2014.01.005

Cited by 24 publications

(29 citation statements)

References 24 publications

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“…Furthermore, studies have demonstrated that patients managed in a multidisciplinary manner by both dermatologists and rheumatologists show improvements in disease activity and quality of life. 21,22 Our results suggest a need for a rheumatologist-dermatologist collaborative approach to optimize management of patients with PsA.…”

Section: Discussionmentioning

confidence: 83%

Association between clinical specialty setting and disease management in patients with psoriatic arthritis: results from LOOP, a cross‐sectional, multi‐country, observational study

Boehncke

Horváth

Dalkılıç

et al. 2020

Acad Dermatol Venereol

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Background Psoriatic arthritis (PsA) is a chronic and debilitating disease that can be managed by different clinical specialists. Objectives The objective of the LOOP study was to evaluate the impact of clinical specialty setting on the time to diagnosis and treatment of patients with PsA. Clinical disease activity and disease burden were also compared between clinical settings. Methods LOOP was a cross‐sectional, multicentre, observational study conducted in 17 countries in Western and Eastern Europe, the Middle East, Latin America and Asia. Adult patients (≥18 years) with a suspected or established diagnosis of PsA who were routinely visiting a rheumatologist, dermatologist or non‐rheumatology/non‐dermatology physician were enrolled. All patients were assessed by both a rheumatologist and a dermatologist. Results Of 1483 enrolled patients, a total of 1273 had a confirmed diagnosis of PsA. There was no significant difference in the median time from onset of inflammatory musculoskeletal symptoms to PsA diagnosis between patients enrolled by rheumatologists and dermatologists (6.0 vs. 3.9 months). However, the median time from diagnosis to first treatment with a conventional synthetic disease‐modifying anti‐rheumatic drug (csDMARD) was significantly shorter in the rheumatology setting compared with the dermatology setting (0 vs. 2.0 months; P < 0.001). In addition, disease activity was significantly higher in the dermatology setting compared with the rheumatology setting. Conclusions Differences in the management and clinical status of patients with PsA were observed between the rheumatology and dermatology settings. Importantly, median time from diagnosis to first csDMARD was significantly shorter in the rheumatology setting, and patients in the dermatology setting had higher disease activity. These data show the importance of improved collaboration between rheumatologists and dermatologists.

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Section: Discussionmentioning

confidence: 83%

Association between clinical specialty setting and disease management in patients with psoriatic arthritis: results from LOOP, a cross‐sectional, multi‐country, observational study

Boehncke

Horváth

Dalkılıç

et al. 2020

Acad Dermatol Venereol

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“…The literature search produced 195 articles, of which 186 were excluded after screening the title and abstract, leaving nine for a full detailed review [2,14,[19][20][21][22][23][24][25]. Another article was identified following the manual search [26].…”

Section: Resultsmentioning

confidence: 99%

“…Recommendations for the coordinated management of the disease based on PsA screening in dermatology and rheumatology clinics and on a concerted monitoring and treatment plan have been developed [7]. Another option is multidisciplinary consultations [14,15], which are supported by the experience of multidisciplinary ophthalmologyrheumatology clinics. Acute anterior uveitis is often associated with spondyloarthritides and may be the first disease manifestation.…”

Section: Introductionmentioning

confidence: 99%

Multidisciplinary dermatology–rheumatology management for patients with moderate-to-severe psoriasis and psoriatic arthritis: a systematic review

et al. 2015

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The aim of the study was to analyze the efficacy and satisfaction of multidisciplinary dermatology-rheumatology management for patients with moderate-to-severe psoriasis and psoriatic arthritis (PsA). We conducted a systematic literature search in MEDLINE, EMBASE, and Cochrane Library up to September 2015. Selection criteria include (1) adult patients with moderate-to-severe psoriasis and PsA, (2) assessed in a multidisciplinary consultation, (3) comparison with routine separate consultations, and (4) outcome measures to evaluate efficacy and/or satisfaction. Meta-analyses, systematic reviews, clinical trials, cohort studies, and case series were included. The quality of the studies included was graded according to the Oxford Level of Evidence scale. Of 195 articles, three studies complied with the inclusion criteria: two case series and one descriptive study in which 506 patients were evaluated. Patients were referred to the multidisciplinary consultation from dermatology and rheumatology consultations in all but one study, in which primary care was also involved. The reason for the referral was to confirm the diagnosis and/or treatment. Patients were evaluated on a weekly and monthly basis in two and one study, respectively. The evidence obtained is scarce but suggests the efficacy of multidisciplinary consultations in terms of improved skin and joint symptoms after changing treatment (82-56 %), showing higher scores for this type of consultation compared to the usual [4.91 vs. 2.85 (0-5)] and a high level of satisfaction among patients (94 % "very satisfied"). However, waiting times were higher. With the limited evidence found, multidisciplinary management seems to be more effective and more satisfactory for patients with moderate-to-severe psoriasis and PsA than conventional consultations, though this could not be conclusively demonstrated. The results of this review support the benefit of implementing this type of consultation.

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“…These perceptions are in accord with recent studies indicating that PsO and PsA multidisciplinary units may facilitate early diagnosis of these conditions, offer a more comprehensive treatment approach and timely treatment initiation, and increase patient satisfaction and quality of life. [21][22][23] Similarly, patients with IBD exposed to a multidisciplinary IBD clinic may have lower rates of IBD-related hospitalization, lower odds of corticosteroid dependence, and lower risk of IBD-related surgeries as compared with patients under standard practice. 24 In addition to the clinical impact of IMIDs on patients in terms of physical suffering, impaired function, and diminished quality of life, these conditions have a significant economic impact on both the individual patient and society as a whole.…”

Section: (3-7)mentioning

confidence: 99%

Improving the standard of care for patients with spondyloarthritis-related immune inflammatory conditions: results of a Delphi study and proposal for early detection

Coto

Riestra

Rozas

et al. 2020

Therapeutic Advances in Chronic Disease

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Background: Our objective was to provide consensus recommendations on the optimal management of the immune-mediated inflammatory diseases (IMIDs) seen in patients with spondyloarthritis (SpA) using a multidisciplinary approach, and to develop a simple tool to help earlier recognition and referral of coexisting IMIDs in patients who already have one type of IMID. Methods: A total of 28 experts in the multidisciplinary management of the SpA-associated IMIDs assessed two questionnaires: one with statements focused on the multidisciplinary management of IMIDs, and a second questionnaire focused on questions useful for early recognition and referral. Panelists assessed the statements with a 9-point ordinal scale (1 = strongly disagree, 9 = strongly agree) using a modified Delphi methodology. Results: Consensus was reached on 72 out of the 82 statements (87.8%). Panelists agreed that the multidisciplinary approach to IMIDs is not sufficiently developed. The creation of multidisciplinary IMID units might be necessary. These units might focus primarily on patients with two or more coexisting IMIDs, or on IMIDs that are especially complex from a diagnostic or therapeutic point of view. Specialists who attend to patients with IMIDs should perform a screening for other coexisting IMIDs. A simple tool to help earlier recognition and referral of coexisting IMIDs is proposed. Conclusions: There is a need to improve care for patients with SpA-associated IMIDs. We provide expert recommendations to guide the adoption of a multidisciplinary approach for these cases, and a simple tool that may be useful for earlier recognition of coexisting IMIDs.

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A Report of 4 Years of Experience of a Multidisciplinary Unit of Psoriasis and Psoriatic Arthritis

Cited by 24 publications

References 24 publications

Association between clinical specialty setting and disease management in patients with psoriatic arthritis: results from LOOP, a cross‐sectional, multi‐country, observational study

Association between clinical specialty setting and disease management in patients with psoriatic arthritis: results from LOOP, a cross‐sectional, multi‐country, observational study

Multidisciplinary dermatology–rheumatology management for patients with moderate-to-severe psoriasis and psoriatic arthritis: a systematic review

Improving the standard of care for patients with spondyloarthritis-related immune inflammatory conditions: results of a Delphi study and proposal for early detection

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