Collaboration in the management of psoriasis and psoriatic arthritis: A survey of joint working in UK clinical practice

Abstract

BackgroundTreatment guidelines for psoriasis and psoriatic arthritis consider all skin and joint domains and recommend collaborative multidisciplinary team (MDT) working. The uptake of joint working in clinical practice for psoriatic disease management has not been well studied.ObjectivesThis United Kingdom (UK) study aimed to provide a better understanding of current working patterns and collaborating specialities, as well as benefits and challenges of combined clinics.MethodsAn online survey was emailed to dermatology and rheumatology healthcare professionals (HCPs) using professional networks.ResultsResponses were received between October 2020 and April 2021 (N = 80); 60.0% of respondents worked in dermatology and 40.0% in rheumatology. Use of combined clinics with dermatology was reported by 40.6% of rheumatology HCPs, including joint (25.0%), parallel (3.1%) and virtual clinics (6.3%), and MDT meetings (6.2%). Similarly, 50.1% of dermatology HCPs reported use of joint (25.0%), parallel (4.2%) and virtual clinics (2.1%), single visits (2.1%), and MDT meetings (16.7%) with rheumatology. Around one‐quarter of respondents collaborated via email, which was also the main method of collaboration with other specialists. Overall, one‐quarter of respondents reported no collaboration in psoriatic disease management. Perceived benefits of combined clinics included shared knowledge, improved patient outcomes and increased patient satisfaction. Challenges included difficulties in aligning clinician time and geographical location, as well as limited ‘buy‐in’ from senior management. Most respondents felt that the COVID‐19 pandemic had partially or significantly impacted combined clinics.ConclusionsThis study is one of the first to survey collaborative working in psoriatic disease management and the first in the UK. These findings demonstrate the variety of approaches used and a lack of collaborative working by one‐quarter of respondents. Despite the benefits, numerous challenges in establishing formal arrangements exist. More evidence is needed to demonstrate improved patient outcomes with collaborative working and to standardise best practice.