Care of patients with psoriasis: an audit of U.K. services in secondary care
D J Eedy, C E M Griffiths, R J G Chalmers, A D Ormerod, C H Smith, J N W N Barker, J Potter, J Ingham, D Lowe, S Burge
Applied Medicine
BACKGROUND: Medical professionals require data about the structure and delivery of dermatological services in primary and secondary care in order to identify and tackle variations in standards and monitor the impact of healthcare reforms. The British Association of Dermatologists (BAD) commissioned an audit of the provision of care for patients with psoriasis. OBJECTIVES: To assess the staffing and facilities in dermatology units in the U.K. with a focus on the provision of care for patients with psoriasis. METHODS: Data were collected from 100 dermatology units in the U.K. for 1 year using a questionnaire and a web-based collection system. RESULTS: Key results are as follows. Eighteen per cent (18/98) of units had fewer than 2.0 whole-time equivalent consultants and 20% had no specialist dermatology nurse. Only 23% of units collected diagnostic data on outpatients, and half were unable to supply details about the number of attendances for psoriasis. Seventy-seven units reported admitting patients to dedicated dermatology beds, general medical beds, or both; three-quarters of units had access to dedicated adult dermatology beds. Pharmacy services were not always available for dermatology patients. Only 21 units (21%) had dedicated clinics for patients with psoriasis and 56% of units lacked a clinical psychology service willing to accept adult dermatology patients; 59% (55/93) lacked psychological services for children. Fifty-five per cent had no systemic drug monitoring clinic. Phototherapy was run by dermatology nurses in 93% (88/95) of the units and by physiotherapists in 11% (10/94). Biologics for psoriasis were prescribed in 75% (73/97) of units and in 88% (64/73) of these the BAD guidelines for the use of biologics were known to be followed. Of the seventy-three units prescribing biologic therapies, 64% had a nurse trained in the assessment and administration of biologics, 71% had facilities for outpatient infusions (e.g. for infliximab) and 39% were restricted in prescribing biologic agents because of financial constraints. A quality-of-life score was either inadequately or never recorded in outpatient records in 81% of units, increasing to 88% for inpatient records. The Psoriasis Area and Severity Index score was inadequately or never recorded in 79% of outpatient records and 82% of inpatient records. CONCLUSIONS: Units varied in their capacity to meet BAD guidelines and standards. Among the most significant deficiencies identified were a shortage of specialist dermatology nurses, treatment delivery by untrained nurses and financial constraints on the prescription of biologics for psoriasis. Gaps in data collection and record keeping jeopardize efforts to improve standards of care.
British Journal of Dermatology
delivery of health care
drug utilization
health care surveys
medical audit
nursing staff, hospital
outpatient clinics, hospital
patient education as topic
referral and consultation
Dive into the research topics of 'Care of patients with psoriasis: an audit of U.K. services in secondary care'. Together they form a unique fingerprint.
Secondary Care Medicine & Life Sciences 100%
Dermatology Medicine & Life Sciences 82%
Psoriasis Medicine & Life Sciences 80%
Dermatologists Medicine & Life Sciences 30%
Outpatients Medicine & Life Sciences 27%
Nurse Specialists Medicine & Life Sciences 24%
Eedy, D. J., Griffiths, C. E. M., Chalmers, R. J. G., Ormerod, A. D., Smith, C. H., Barker, J. N. W. N., Potter, J., Ingham, J., Lowe, D., & Burge, S. (2009). Care of patients with psoriasis: an audit of U.K. services in secondary care. British Journal of Dermatology, 160(3), 557-564. https://doi.org/10.1111/j.1365-2133.2008.08987.x
Care of patients with psoriasis : an audit of U.K. services in secondary care. / Eedy, D J; Griffiths, C E M; Chalmers, R J G et al.
In: British Journal of Dermatology, Vol. 160, No. 3, 03.2009, p. 557-564.
Eedy, DJ, Griffiths, CEM, Chalmers, RJG, Ormerod, AD, Smith, CH, Barker, JNWN, Potter, J, Ingham, J, Lowe, D & Burge, S 2009, 'Care of patients with psoriasis: an audit of U.K. services in secondary care', British Journal of Dermatology, vol. 160, no. 3, pp. 557-564. https://doi.org/10.1111/j.1365-2133.2008.08987.x
Eedy DJ, Griffiths CEM, Chalmers RJG, Ormerod AD, Smith CH, Barker JNWN et al. Care of patients with psoriasis: an audit of U.K. services in secondary care. British Journal of Dermatology. 2009 Mar;160(3):557-564. https://doi.org/10.1111/j.1365-2133.2008.08987.x
Eedy, D J ; Griffiths, C E M ; Chalmers, R J G et al. / Care of patients with psoriasis : an audit of U.K. services in secondary care. In: British Journal of Dermatology. 2009 ; Vol. 160, No. 3. pp. 557-564.
@article{a4fb237a3de64990a98d195c2dbdd2ea,
title = "Care of patients with psoriasis: an audit of U.K. services in secondary care",
abstract = "BACKGROUND: Medical professionals require data about the structure and delivery of dermatological services in primary and secondary care in order to identify and tackle variations in standards and monitor the impact of healthcare reforms. The British Association of Dermatologists (BAD) commissioned an audit of the provision of care for patients with psoriasis. OBJECTIVES: To assess the staffing and facilities in dermatology units in the U.K. with a focus on the provision of care for patients with psoriasis. METHODS: Data were collected from 100 dermatology units in the U.K. for 1 year using a questionnaire and a web-based collection system. RESULTS: Key results are as follows. Eighteen per cent (18/98) of units had fewer than 2.0 whole-time equivalent consultants and 20% had no specialist dermatology nurse. Only 23% of units collected diagnostic data on outpatients, and half were unable to supply details about the number of attendances for psoriasis. Seventy-seven units reported admitting patients to dedicated dermatology beds, general medical beds, or both; three-quarters of units had access to dedicated adult dermatology beds. Pharmacy services were not always available for dermatology patients. Only 21 units (21%) had dedicated clinics for patients with psoriasis and 56% of units lacked a clinical psychology service willing to accept adult dermatology patients; 59% (55/93) lacked psychological services for children. Fifty-five per cent had no systemic drug monitoring clinic. Phototherapy was run by dermatology nurses in 93% (88/95) of the units and by physiotherapists in 11% (10/94). Biologics for psoriasis were prescribed in 75% (73/97) of units and in 88% (64/73) of these the BAD guidelines for the use of biologics were known to be followed. Of the seventy-three units prescribing biologic therapies, 64% had a nurse trained in the assessment and administration of biologics, 71% had facilities for outpatient infusions (e.g. for infliximab) and 39% were restricted in prescribing biologic agents because of financial constraints. A quality-of-life score was either inadequately or never recorded in outpatient records in 81% of units, increasing to 88% for inpatient records. The Psoriasis Area and Severity Index score was inadequately or never recorded in 79% of outpatient records and 82% of inpatient records. CONCLUSIONS: Units varied in their capacity to meet BAD guidelines and standards. Among the most significant deficiencies identified were a shortage of specialist dermatology nurses, treatment delivery by untrained nurses and financial constraints on the prescription of biologics for psoriasis. Gaps in data collection and record keeping jeopardize efforts to improve standards of care.",
keywords = "biological products, consultants, delivery of health care, drug utilization, health care surveys, health services research, hospital units, hospitalization, humans, medical audit, medical records, nursing staff, hospital, outpatient clinics, hospital, patient education as topic, primary health care , psoriasis, referral and consultation, waiting lists, audit, dermatology",
author = "Eedy, {D J} and Griffiths, {C E M} and Chalmers, {R J G} and Ormerod, {A D} and Smith, {C H} and Barker, {J N W N} and J Potter and J Ingham and D Lowe and S Burge",
journal = "British Journal of Dermatology",
T1 - Care of patients with psoriasis
T2 - an audit of U.K. services in secondary care
AU - Eedy, D J
AU - Griffiths, C E M
AU - Chalmers, R J G
AU - Ormerod, A D
AU - Smith, C H
AU - Barker, J N W N
AU - Potter, J
AU - Ingham, J
AU - Lowe, D
AU - Burge, S
N2 - BACKGROUND: Medical professionals require data about the structure and delivery of dermatological services in primary and secondary care in order to identify and tackle variations in standards and monitor the impact of healthcare reforms. The British Association of Dermatologists (BAD) commissioned an audit of the provision of care for patients with psoriasis. OBJECTIVES: To assess the staffing and facilities in dermatology units in the U.K. with a focus on the provision of care for patients with psoriasis. METHODS: Data were collected from 100 dermatology units in the U.K. for 1 year using a questionnaire and a web-based collection system. RESULTS: Key results are as follows. Eighteen per cent (18/98) of units had fewer than 2.0 whole-time equivalent consultants and 20% had no specialist dermatology nurse. Only 23% of units collected diagnostic data on outpatients, and half were unable to supply details about the number of attendances for psoriasis. Seventy-seven units reported admitting patients to dedicated dermatology beds, general medical beds, or both; three-quarters of units had access to dedicated adult dermatology beds. Pharmacy services were not always available for dermatology patients. Only 21 units (21%) had dedicated clinics for patients with psoriasis and 56% of units lacked a clinical psychology service willing to accept adult dermatology patients; 59% (55/93) lacked psychological services for children. Fifty-five per cent had no systemic drug monitoring clinic. Phototherapy was run by dermatology nurses in 93% (88/95) of the units and by physiotherapists in 11% (10/94). Biologics for psoriasis were prescribed in 75% (73/97) of units and in 88% (64/73) of these the BAD guidelines for the use of biologics were known to be followed. Of the seventy-three units prescribing biologic therapies, 64% had a nurse trained in the assessment and administration of biologics, 71% had facilities for outpatient infusions (e.g. for infliximab) and 39% were restricted in prescribing biologic agents because of financial constraints. A quality-of-life score was either inadequately or never recorded in outpatient records in 81% of units, increasing to 88% for inpatient records. The Psoriasis Area and Severity Index score was inadequately or never recorded in 79% of outpatient records and 82% of inpatient records. CONCLUSIONS: Units varied in their capacity to meet BAD guidelines and standards. Among the most significant deficiencies identified were a shortage of specialist dermatology nurses, treatment delivery by untrained nurses and financial constraints on the prescription of biologics for psoriasis. Gaps in data collection and record keeping jeopardize efforts to improve standards of care.
AB - BACKGROUND: Medical professionals require data about the structure and delivery of dermatological services in primary and secondary care in order to identify and tackle variations in standards and monitor the impact of healthcare reforms. The British Association of Dermatologists (BAD) commissioned an audit of the provision of care for patients with psoriasis. OBJECTIVES: To assess the staffing and facilities in dermatology units in the U.K. with a focus on the provision of care for patients with psoriasis. METHODS: Data were collected from 100 dermatology units in the U.K. for 1 year using a questionnaire and a web-based collection system. RESULTS: Key results are as follows. Eighteen per cent (18/98) of units had fewer than 2.0 whole-time equivalent consultants and 20% had no specialist dermatology nurse. Only 23% of units collected diagnostic data on outpatients, and half were unable to supply details about the number of attendances for psoriasis. Seventy-seven units reported admitting patients to dedicated dermatology beds, general medical beds, or both; three-quarters of units had access to dedicated adult dermatology beds. Pharmacy services were not always available for dermatology patients. Only 21 units (21%) had dedicated clinics for patients with psoriasis and 56% of units lacked a clinical psychology service willing to accept adult dermatology patients; 59% (55/93) lacked psychological services for children. Fifty-five per cent had no systemic drug monitoring clinic. Phototherapy was run by dermatology nurses in 93% (88/95) of the units and by physiotherapists in 11% (10/94). Biologics for psoriasis were prescribed in 75% (73/97) of units and in 88% (64/73) of these the BAD guidelines for the use of biologics were known to be followed. Of the seventy-three units prescribing biologic therapies, 64% had a nurse trained in the assessment and administration of biologics, 71% had facilities for outpatient infusions (e.g. for infliximab) and 39% were restricted in prescribing biologic agents because of financial constraints. A quality-of-life score was either inadequately or never recorded in outpatient records in 81% of units, increasing to 88% for inpatient records. The Psoriasis Area and Severity Index score was inadequately or never recorded in 79% of outpatient records and 82% of inpatient records. CONCLUSIONS: Units varied in their capacity to meet BAD guidelines and standards. Among the most significant deficiencies identified were a shortage of specialist dermatology nurses, treatment delivery by untrained nurses and financial constraints on the prescription of biologics for psoriasis. Gaps in data collection and record keeping jeopardize efforts to improve standards of care.
KW - biological products
KW - consultants
KW - delivery of health care
KW - drug utilization
KW - health care surveys
KW - health services research
KW - hospital units
KW - hospitalization
KW - medical audit
KW - medical records
KW - nursing staff, hospital
KW - outpatient clinics, hospital
KW - patient education as topic
KW - primary health care
KW - psoriasis
KW - referral and consultation
KW - waiting lists
KW - audit
KW - dermatology
JO - British Journal of Dermatology
JF - British Journal of Dermatology