Hong Cassandra, Fang Sarah, Yeo Yi-Wei, Koh Hong-Yi, Lee Haur Yueh, Low Andrea Hsiu-Ling, Leung Ying-Ying
Department of Rheumatology & Immunology, Singapore General Hospital, Singapore, Singapore.
Department of Dermatology, Singapore General Hospital, Singapore, Singapore.
Int J Rheum Dis. 2022 Aug;25(8):861-868. doi: 10.1111/1756-185X.14359. Epub 2022 Jun 30.
We described the set-up of a new multidisciplinary psoriatic arthritis-psoriasis (PsA-PsO) clinic incorporating service, education, and research between rheumatologists and dermatologists for PsA. We describe the patients' and learners' experience of this shared-care model.
A PsA-PsO clinic was newly set up in 2019. Each patient was first seen by a trainee, followed by both a dermatologist and a rheumatologist simultaneously in the same consultation room. We collected patients' and learners' experience through self-administered surveys.
From May 2019 to January 2020, we collected data from 44 visits (55% new referrals, 45% follow up) from 30 patients: 22.7% were referred for diagnostic doubts, 77.3% were for therapeutic issues. Eight of the 10 patients referred for diagnosis had PsA confirmed. Medication changes occurred in 63.6% of visits; 63.6% of patients continued follow up in the PsA-PsO clinic, and 36.4% were discharged back to the original respective care. The median (interquartile range) rating of patient satisfaction of the care was 8 (7-8) out of 10; 96.1% of patients would "probably" or "definitely recommend" the care to others. From 20 learners, 95% reported the experience as "extremely" or "very" beneficial to training. The PsA-PsO clinic was suspended during the COVID-19 pandemic from February 2020 because of lack of available staff. The service was resumed gradually from May 2021.
Despite challenges, we report the set-up of a new care model between dermatologists and rheumatologists for care of patients with psoriatic disease. The care model was well received by patients. Learners from various levels reported benefit from the learning experience.
我们描述了一个新的多学科银屑病关节炎 - 银屑病（PsA - PsO）诊所的设立情况，该诊所整合了风湿病学家和皮肤科医生针对PsA的服务、教育及研究。我们描述了患者和学习者对这种共享护理模式的体验。
2019年新设立了一个PsA - PsO诊所。每位患者首先由一名实习生接诊，随后皮肤科医生和风湿病学家在同一咨询室同时进行会诊。我们通过自行填写的调查问卷收集患者和学习者的体验。
从2019年5月至2020年1月，我们收集了30名患者44次就诊的数据（55%为新转诊患者，45%为随访患者）：22.7%因诊断存疑而转诊，77.3%因治疗问题转诊。10名转诊进行诊断的患者中有8名确诊为PsA。63.6%的就诊患者发生了药物调整；63.6%的患者继续在PsA - PsO诊所随访，36.4%的患者转回原各自的护理机构。患者对护理满意度的中位数（四分位间距）评分为8（7 - 8）分（满分10分）；96.1%的患者“可能”或“肯定”会向他人推荐这种护理。在20名学习者中，95%报告称该体验对培训“极其”或“非常”有益。由于缺乏可用工作人员，PsA - PsO诊所在2020年2月新冠疫情期间暂停服务。该服务于2021年5月逐渐恢复。
尽管存在挑战，但我们报告了皮肤科医生和风湿病学家之间为银屑病患者设立的一种新护理模式。这种护理模式受到患者好评。不同层次的学习者都报告称从学习体验中受益。
