Department of Medicine, Division of Rheumatology, New York University Langone Health, New York, NY, USA.
Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA.
Curr Rheumatol Rep. 2018 Oct 26;20(12):76. doi: 10.1007/s11926-018-0785-6.
Despite a robust therapeutic landscape, significant gaps exist in the quality of care of psoriatic disease. Thus, an improved understanding of the challenges in providing quality care and the implementation of effective strategies to overcome them is needed. In this review, we summarize the burden of psoriatic disease, discuss the challenges in the care of psoriatic patients, and outline how combined dermatology-rheumatology clinics bridge many of these gaps.
Multiple challenges are faced in providing high-quality care to patients with psoriasis and psoriatic arthritis from the pre-diagnosis phase of disease to the follow-up period. Challenges are mainly driven by lack of education of patients and healthcare providers, inefficient communication between specialists, lack of a holistic approach to patients, and limitations of available therapies. The Psoriasis and Psoriatic Arthritis Clinics Multicenter Advancement Network (PPACMAN) is working on demonstrating the effectiveness of combined dermatology-rheumatology clinics in addressing some of these challenges. Recent findings show that combined clinic models may improve quality of care by raising awareness of psoriatic disease, fostering educational activities for both patients and physicians, and allowing for comprehensive evaluation and management of patients through improved communications between disciplines. Psoriasis and psoriatic arthritis are complex diseases that often require an interdisciplinary approach. Thus, combined dermatology-rheumatology clinics and local-regional partnerships are potentially effective in improving quality of care in psoriatic disease.
目的综述:尽管治疗方法多样,但在银屑病的护理质量上仍存在明显不足。因此,需要更好地理解在提供优质护理方面存在的挑战,并实施有效的策略来克服这些挑战。在这篇综述中,我们总结了银屑病疾病的负担,讨论了银屑病患者护理方面的挑战,并概述了皮肤科-风湿病学联合诊所如何弥合这些差距。
最新发现:从疾病的预诊断阶段到随访阶段,为银屑病和银屑病关节炎患者提供高质量的护理存在多种挑战。这些挑战主要是由于患者和医疗保健提供者缺乏教育、专家之间沟通效率低下、对患者缺乏整体治疗方法以及现有治疗方法的局限性造成的。银屑病和银屑病关节炎诊所多中心进步网络(PPACMAN)正在努力证明联合皮肤科-风湿病学诊所在解决其中一些挑战方面的有效性。最近的研究结果表明,联合诊所模式可以通过提高对银屑病疾病的认识、为患者和医生提供教育活动以及通过改善学科间的沟通来对患者进行全面评估和管理,从而提高护理质量。银屑病和银屑病关节炎是复杂的疾病,通常需要多学科的方法。因此,联合皮肤科-风湿病学诊所和地方-区域合作关系有可能改善银屑病疾病的护理质量。