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医疗服务提供者在治疗银屑病患者时面临诸多挑战:一项混合方法研究的结果

Healthcare Providers Face Numerous Challenges in Treating Patients with Psoriasis: Results from a Mixed-Methods Study.

作者信息

Murray Suzanne, Crowley Jeffrey, Gooderham Melinda J, Kivitz Alan, Chandran Vinod, Péloquin Sophie, Doghramji Paul P, Freeman Christie, Lazure Patrice

机构信息

AXDEV Group Inc, Brossard, Quebec, Canada.

Bakersfield Dermatology and Skin Cancer Medical Group, Bakersfield, CA, USA.

出版信息

J Psoriasis Psoriatic Arthritis. 2022 Jan;7(1):35-43. doi: 10.1177/24755303211062887. Epub 2021 Dec 7.

Abstract

BACKGROUND

The paradigm shift toward biologic medications in psoriasis care requires healthcare providers (HCPs) to become acquainted with mechanisms of action and safety profiles of these new treatments to confidently use them in practice. A better understanding of this paradigm shift is necessary to provide adequate education for HCPs in psoriasis care.

OBJECTIVES

This study assessed clinical practice gaps and challenges experienced by HCPs caring for patients with psoriasis.

METHODS

A mixed-methods approach was used to identify practice gaps and clinical challenges of dermatologists, rheumatologists, primary care physicians, physician assistants, and nurse practitioners with various levels of clinical experience in academic and community-based settings. Qualitative and quantitative data were collected sequentially. Interviews were transcribed and thematically analyzed.

RESULTS

A total of 380 psoriasis care providers in Canada and the US participated in this study. Analysis revealed challenges in establishing an accurate diagnosis of psoriasis (including screening for sub-type and distinguishing psoriasis from other skin conditions), selecting treatment (particularly regarding recently approved treatments), monitoring side effects, and collaborating with other HCPs involved in psoriasis care.

CONCLUSION

These findings highlight educational needs of HCPs involved in psoriasis care that could have repercussions on accurate and timely diagnosis of the condition, treatment initiation, side effect monitoring, and continuity of care. Findings provide a starting point for clinicians to reflect on their practice and for the improvement of continuing professional development interventions that would bridge these gaps.

摘要

背景

银屑病治疗向生物制剂的模式转变要求医疗服务提供者(HCPs)熟悉这些新疗法的作用机制和安全性,以便在实践中自信地使用它们。为银屑病护理领域的HCPs提供充分教育,有必要更好地理解这一模式转变。

目的

本研究评估了护理银屑病患者的HCPs所经历的临床实践差距和挑战。

方法

采用混合方法来确定在学术和社区环境中具有不同临床经验水平的皮肤科医生、风湿病学家、初级保健医生、医师助理和执业护士的实践差距和临床挑战。定性和定量数据按顺序收集。访谈内容进行转录并进行主题分析。

结果

加拿大和美国共有380名银屑病护理提供者参与了本研究。分析显示,在准确诊断银屑病(包括筛查亚型以及将银屑病与其他皮肤疾病区分开来)、选择治疗方法(特别是对于最近批准的治疗方法)、监测副作用以及与参与银屑病护理的其他HCPs协作方面存在挑战。

结论

这些发现凸显了参与银屑病护理的HCPs的教育需求,这些需求可能会对该疾病的准确及时诊断、治疗启动、副作用监测以及护理连续性产生影响。研究结果为临床医生反思其实践以及改进能够弥合这些差距的继续职业发展干预措施提供了一个起点。

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How to Construct a Mixed Methods Research Design.如何构建混合方法研究设计。
Kolner Z Soz Sozpsychol. 2017;69(Suppl 2):107-131. doi: 10.1007/s11577-017-0454-1. Epub 2017 Jul 5.
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Psoriasis for the primary care practitioner.初级保健医生的银屑病
J Am Assoc Nurse Pract. 2017 Mar;29(3):157-178. doi: 10.1002/2327-6924.12443. Epub 2017 Feb 23.
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