Luelmo Jesus, Gratacós Jordi, Moreno Martínez-Losa Mireia, Ribera Miguel, Romaní Jorge, Calvet Juan, Leal Lorena, Larrosa Marta
Servicio de Dermatología, Hospital Universitario Parc Taulí de Sabadell, Universidad Autónoma de Barcelona, Barcelona, España.
Servicio de Reumatología, Hospital Universitario Parc Taulí de Sabadell, Universidad Autónoma de Barcelona, Barcelona, España.
Reumatol Clin. 2014 May-Jun;10(3):141-6. doi: 10.1016/j.reuma.2014.01.004. Epub 2014 Mar 20.
Up to 30% of patients with psoriasis develop joint disease, the course of which can be improved by early diagnosis and treatment. The aim of this study was to describe our experience with a new multidisciplinary psoriasis and psoriatic arthritis unit over a period of 4 years (2009-2012).
Implementation of a PSOriasis Rheumatology and Dermatology unit (PSORD) to provide patient care and physician training. In the first phase of the project, referral criteria for the unit were defined and several meetings were organized to train and prepare the specialists involved in the program. In the second phase, a schedule was drawn up for monthly patient visits with the PSORD team. Starting in 2011, training was offered to dermatologists and rheumatologists from other hospitals interested in implementing a similar model.
A total of 259 visits (71% first visits, 8% no-shows) were scheduled during the period analyzed, with a median of 8 visits (range, 2-14 visits) per session. Sixty-three percent of the patients were referred from the rheumatology department. Diagnosis and treatment were modified in 32% and 47% of cases, respectively. Three training courses were held with 15 physicians from 6 hospitals, 3 of which created similar units.
The PSORD model improved the management of difficult-to-diagnose and/or uncontrolled disease, the early diagnosis and treatment of psoriatic arthritis, and collaboration between dermatologists and rheumatologists. Finally, the model lends itself to being exported to other settings.
高达30%的银屑病患者会发展为关节疾病，早期诊断和治疗可改善其病程。本研究的目的是描述我们在一个新的多学科银屑病和银屑病关节炎诊疗单元4年（2009 - 2012年）期间的经验。
设立一个银屑病风湿病与皮肤病诊疗单元（PSORD）以提供患者护理和医师培训。在项目的第一阶段，确定了该诊疗单元的转诊标准，并组织了几次会议来培训和筹备参与该项目的专家。在第二阶段，制定了PSORD团队每月患者就诊时间表。从2011年开始，为其他有兴趣实施类似模式的医院的皮肤科医生和风湿病医生提供培训。
在所分析的期间内共安排了259次就诊（71%为首次就诊，8%未就诊），每次就诊的中位数为8次（范围为2 - 14次）。63%的患者由风湿病科转诊。分别有32%和47%的病例的诊断和治疗得到了调整。为来自6家医院的15名医生举办了3期培训课程，其中3家医院设立了类似单元。
PSORD模式改善了对难以诊断和/或控制疾病的管理、银屑病关节炎的早期诊断和治疗以及皮肤科医生和风湿病医生之间的协作。最后，该模式便于推广至其他机构。
