The implementation of a structured specialized consultation for psoriasis management

Abstract

Objectives: Psoriasis is a chronic skin disease requiring a multidimensional approach, given its varying appearance, presence of comorbidities and complex treatment regimens. Psoriasis care is however often performed fragmented and, in case of flares, reactive with little integrated information on and for the patient. Literature suggests a multileveled approach of psoriasis, but the effects of its implementation have not yet been validated. The aim of this study is to analyze the impact of a multileveled psoriasis consultation format, named PsoPlus, which has been implemented since 2012 in the Department of Dermatology at Ghent University Hospital in Belgium.Methods: The patient population was divided into two groups: one following the regular consultation and one following the PsoPlus format. Demographic data, clinical outcome and treatment approach of psoriasis patients were compared.Results: Patients who opted for the specialized PsoPlus consultation were younger and had longer disease duration. Decision parameters such as disease severity and quality of life were reported more often in the PsoPlus group. In the latter, a higher rate of patients were started on systemic therapy compared to the regular consultation group, and reporting on adverse events was done more frequently. Conclusion:The implementation of a specialized consultation with comprehensive guidance facilitates documentation on disease-relevant parameters such as disease severity and quality of life. This format can be seen as a guidance for capturing data in a structured manner, with evidence showing that it significantly impacts treatment decision, treating not only psoriasis but the patient as a whole.

Initiating value‐based healthcare in psoriasis: Proposing a value‐based outcome set for daily clinical practice

“…In IPUs, care is organized around a patient's medical condition and a dedicated multidisciplinary team provides a broad range of services over the full care cycle for the patient's condition 6 . Examples of IPUs for chronic inflammatory skin diseases include our PsoPlus clinic and the US‐based Psoriasis and Psoriatic Arthritis Clinics Multicenter Advancement Network (PPACMAN) 19,20,36 . Delivering integrated care using combined dermatology–rheumatology clinics has already shown to improve outcomes as well as patient and physician satisfaction in certain chronic inflammatory skin diseases 37 .…”

“…These 23 outcomes were then presented to a group of patients, using a modified nominal group technique (NGT), to establish whether these results represented all of their relevant outcomes. Subsequently, these outcomes were ranked according to importance by 120 patients attending our academic specialized psoriasis clinic (PsoPlus) at Ghent University Hospital, Belgium 19,20 . A review of the literature was performed to assess which instruments were available and suitable to evaluate the outcomes in this VOS.…”

“…Subsequently, these outcomes were ranked according to importance by 120 patients attending our academic specialized psoriasis clinic (PsoPlus) at Ghent University Hospital, Belgium. 19,20 A review of the literature was performed to assess which instruments were available and suitable to evaluate the outcomes in this VOS. Finally, we explored the feasibility of the VOS in a pilot test involving 10 patients.…”

“…6 Examples of IPUs for chronic inflammatory skin diseases include our PsoPlus clinic and the US-based Psoriasis and Psoriatic Arthritis Clinics Multicenter Advancement Network (PPACMAN). 19,20,36 Delivering integrated care using combined dermatology-rheumatology clinics has already shown to improve outcomes as well as patient and physician satisfaction in certain chronic inflammatory skin diseases. 37 Furthermore, healthcare reimbursement systems need to employ alternative payment models (APMs) and move away from fees for individual services.…”

Blocking interleukin‐17 in psoriasis: Real‐world experience from the PsoPlus cohort

“…[25][26][27][28][29][30][31][32][33][34][35][36][37][38] Here, we present a cohort of IL-17i-treated Pso patients, followed up in a monocentric, academic, Pso-dedicated, integrated care setting, named PsoPlus. 39 Our objectives were to (1) present IL-17i effectiveness, (2) report on treatment modifications and (3) describe the utility of C t measurements during clinical practice.…”