Quality of care in dermatology. The state of (measuring) the art

Chren, M. M.

doi:10.1001/archderm.133.11.1349

Cited by 10 publications

(11 citation statements)

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“…Physicians are increasingly challenged to demonstrate the quality of their treatment (‘quality of care’). The quality of the care is directed at the assessment and the improvement of treatment outcome 19 . In general, quality of care measures include adherence to treatment advice, communication skills and appropriate advice on self‐management or medication.…”

Section: Discussionmentioning

confidence: 99%

A randomized controlled trial in children with eczema: nurse practitioner vs. dermatologist

Schuttelaar

Vermeulen

Drukker

et al. 2009

British Journal of Dermatology

147

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Background We hypothesized that a nurse practitioner would improve the quality of life of a child with eczema more than a dermatologist because of a structured intervention and more consultation time. Objectives To compare the level of care by nurse practitioners with that by dermatologists in children with eczema. Methods New referrals aged < or = 16 years with a diagnosis of eczema were recruited. In a randomized, parallel-group study with a follow-up period of 1 year, 160 participants were randomized either to conventional care from a dermatologist or to care from a nurse practitioner. The primary outcome measure was change in quality of life at 12 months, as assessed by the Infants' Dermatitis Quality of Life Index (IDQOL) for children aged < or = 4 years, and by the illustrated version of the Children's Dermatology Life Quality Index (CDLQI) for children aged 4-16 years. Secondary outcomes were changes in IDQOL and CDLQI at 4 and 8 months, family impact of childhood atopic dermatitis (Dermatitis Family Impact Questionnaire, DFI), eczema severity (objective SCORAD) and patient satisfaction (Client Satisfaction Questionnaire-8, CSQ-8) at 4, 8 and 12 months. Results The mean IDQOL in the dermatologist group improved significantly from 11.6 [SD 8.1; 95% confidence interval (CI) 9.0-14.2] at the baseline to 5.6 (SD 3.9; 95% CI 4.3-7.0) at 12 months with a mean change from the baseline of -6.5 (SD 6.6; 95% CI -14.2 to -8.9; P < 0.001). The mean IDQOL in the nurse practitioner group improved significantly from 10.7 (SD 4.9; 95% CI 9.1-12.3) at baseline to 5.7 (SD 5.4; 95% CI 4.0-7.5) at 12 months with a mean change from the baseline of -4.9 (SD 5.5; 95% CI -6.8 to -3.0; P < 0.001). The between-groups difference was (-)1.7 (95% CI -4.6 to 1.2; P = 0.26). The mean CDLQI in the dermatologist group improved significantly from 12.1 (SD 6.3; 95% CI 9.9-14.2) at baseline to 5.6 (SD 4.2; 95% CI 4.2-7.1) at 12 months with a mean change from the baseline of -5.9 (SD 6.0; 95% CI -8.0 to -3.9; P < 0.001). The mean CDLQI in the nurse practitioner group improved significantly from 10.0 (SD 4.4; 95% CI 8.5-11.4) at the baseline to 4.9 (SD 3.5; 95% CI 3.7-6.1) at 12 months with a mean change from the baseline of -5.2 (SD 4.0; 95% CI -6.6 to -3.8; P < 0.001). The between-groups difference was (-)0.7 (95% CI -3.3 to 1.7; P = 0.55). The between-groups comparison was not significant for the IDQOL and the CDLQI at baseline or 4, 8 and 12 months. Both treatment groups showed significant improvement in DFI and objective SCORAD at 12 months. The between-groups comparison was not significant at baseline or 4, 8 and 12 months. Significantly higher satisfaction levels were observed at 4, 8 and 12 months in the nurse practitioner group. Conclusions The level of care provided by a nurse practitioner in terms of the improvement in the eczema severity and the quality of life outcomes was comparable with that provided by a dermatologist. In addition, the parents were more satisfied with the care that was provided by a nurse practitioner.

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Section: Discussionmentioning

confidence: 99%

A randomized controlled trial in children with eczema: nurse practitioner vs. dermatologist

Schuttelaar

Vermeulen

Drukker

et al. 2009

British Journal of Dermatology

147

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“…Quality of care is directed towards the assessment and improvement of treatment outcome. 1,2 Health authorities, insurance companies and patients are more and more interested in the quality of health services. Physicians are increasingly challenged to demonstrate the quality of their treatment.…”

Section: Quality Of Carementioning

confidence: 99%

Quality of care in patients with psoriasis: an initial clinical study of an international disease management programme

Korte¹,

Onselen²,

Kownacki

et al. 2004

Acad Dermatol Venereol

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“…Skindex is an American instrument to measure quality of life in dermatology 16,17 , 18 . Our goal was to create a semantic equivalent translation of the 29‐item version of Skindex into Spanish, and to begin evaluation of its measurement properties.…”

Section: Introductionmentioning

confidence: 99%