Management of a Chronic Skin Disease in Primary Care: An Analysis of Early-Career General Practitioners’ Consultations Involving Psoriasis

Background: The management of psoriasis by general practitioners (GPs) is vital, given its prevalence, chronicity, and associated physical and psychosocial co-morbidities. However, there is little information on how GPs (including early-career GPs) manage psoriasis. Objectives: This study assess...

Descripción completa

Guardado en:
Detalles Bibliográficos
Autores principales: Sameerah Nawaz, Amanda Tapley, Andrew Davey, Mieke L. van Driel, Alison Fielding, Elizabeth Holliday, Jean Ball, Irena Patsan, Alyse Berrigan, Simon Morgan, Neil Spike, Kristen FitzGerald, Parker Magin
Formato: article
Lenguaje:EN
Publicado: Mattioli1885 2021
Materias:
Acceso en línea:https://doaj.org/article/5c3a150082844913ac07c6c782610efd
Etiquetas: Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
id oai:doaj.org-article:5c3a150082844913ac07c6c782610efd
record_format dspace
spelling oai:doaj.org-article:5c3a150082844913ac07c6c782610efd2021-11-17T08:27:54ZManagement of a Chronic Skin Disease in Primary Care: An Analysis of Early-Career General Practitioners’ Consultations Involving Psoriasis10.5826/dpc.1103a552160-9381https://doaj.org/article/5c3a150082844913ac07c6c782610efd2021-05-01T00:00:00Zhttp://dpcj.org/index.php/dpc/article/view/1557https://doaj.org/toc/2160-9381 Background: The management of psoriasis by general practitioners (GPs) is vital, given its prevalence, chronicity, and associated physical and psychosocial co-morbidities. However, there is little information on how GPs (including early-career GPs) manage psoriasis. Objectives: This study assessed the frequency with which Australian specialist GP vocational trainees (‘registrars’) provide psoriasis care and the associations of that clinical experience. Methods: A cross-sectional analysis was done of data from the ReCEnT study, an ongoing multi-site cohort study of Australian GP registrars’ experiences during vocational training. In ReCEnT, 60 consecutive consultations are recorded 3 times (6-monthly) during each registrar's training. The outcome factor for this analysis was a problem/diagnosis being psoriasis, and independent variables were related to registrar, patient, practice and consultation factors. This study analysed 17 rounds of data collection (2010-2017) using univariate and multivariable regression. Results: Data from 1,741 registrars regarding 241,888 consultations and 377,980 problems/diagnoses were analysed. Psoriasis comprised 0.15% (n=550) of all problems/diagnoses (95% CI, 0.13-0.16). Significant patient multivariable associations of a problem/diagnosis being psoriasis included age, gender, being new to a practice or a registrar, and psoriasis being an existing problem rather than a new diagnosis. Significant registrar associations included seeking in-consultation information/assistance, not scheduling a follow-up appointment, prescribing medication, and generating learning goals. Conclusions: Australian registrars have modest training exposure to psoriasis and may find psoriasis management challenging. Furthermore, continuity of care (essential for optimal chronic disease management) was modest. The findings have implications for GPs’ approaches to the management of psoriasis more widely as well for general practice education and training policies. Sameerah NawazAmanda TapleyAndrew DaveyMieke L. van DrielAlison FieldingElizabeth HollidayJean BallIrena PatsanAlyse BerriganSimon MorganNeil SpikeKristen FitzGeraldParker MaginMattioli1885articlepsoriasiscontinuity of patient caremedical and graduate educationchronic diseasefamily practicegeneral practiceDermatologyRL1-803ENDermatology Practical & Conceptual (2021)
institution DOAJ
collection DOAJ
language EN
topic psoriasis
continuity of patient care
medical and graduate education
chronic disease
family practice
general practice
Dermatology
RL1-803
spellingShingle psoriasis
continuity of patient care
medical and graduate education
chronic disease
family practice
general practice
Dermatology
RL1-803
Sameerah Nawaz
Amanda Tapley
Andrew Davey
Mieke L. van Driel
Alison Fielding
Elizabeth Holliday
Jean Ball
Irena Patsan
Alyse Berrigan
Simon Morgan
Neil Spike
Kristen FitzGerald
Parker Magin
Management of a Chronic Skin Disease in Primary Care: An Analysis of Early-Career General Practitioners’ Consultations Involving Psoriasis
description Background: The management of psoriasis by general practitioners (GPs) is vital, given its prevalence, chronicity, and associated physical and psychosocial co-morbidities. However, there is little information on how GPs (including early-career GPs) manage psoriasis. Objectives: This study assessed the frequency with which Australian specialist GP vocational trainees (‘registrars’) provide psoriasis care and the associations of that clinical experience. Methods: A cross-sectional analysis was done of data from the ReCEnT study, an ongoing multi-site cohort study of Australian GP registrars’ experiences during vocational training. In ReCEnT, 60 consecutive consultations are recorded 3 times (6-monthly) during each registrar's training. The outcome factor for this analysis was a problem/diagnosis being psoriasis, and independent variables were related to registrar, patient, practice and consultation factors. This study analysed 17 rounds of data collection (2010-2017) using univariate and multivariable regression. Results: Data from 1,741 registrars regarding 241,888 consultations and 377,980 problems/diagnoses were analysed. Psoriasis comprised 0.15% (n=550) of all problems/diagnoses (95% CI, 0.13-0.16). Significant patient multivariable associations of a problem/diagnosis being psoriasis included age, gender, being new to a practice or a registrar, and psoriasis being an existing problem rather than a new diagnosis. Significant registrar associations included seeking in-consultation information/assistance, not scheduling a follow-up appointment, prescribing medication, and generating learning goals. Conclusions: Australian registrars have modest training exposure to psoriasis and may find psoriasis management challenging. Furthermore, continuity of care (essential for optimal chronic disease management) was modest. The findings have implications for GPs’ approaches to the management of psoriasis more widely as well for general practice education and training policies.
format article
author Sameerah Nawaz
Amanda Tapley
Andrew Davey
Mieke L. van Driel
Alison Fielding
Elizabeth Holliday
Jean Ball
Irena Patsan
Alyse Berrigan
Simon Morgan
Neil Spike
Kristen FitzGerald
Parker Magin
author_facet Sameerah Nawaz
Amanda Tapley
Andrew Davey
Mieke L. van Driel
Alison Fielding
Elizabeth Holliday
Jean Ball
Irena Patsan
Alyse Berrigan
Simon Morgan
Neil Spike
Kristen FitzGerald
Parker Magin
author_sort Sameerah Nawaz
title Management of a Chronic Skin Disease in Primary Care: An Analysis of Early-Career General Practitioners’ Consultations Involving Psoriasis
title_short Management of a Chronic Skin Disease in Primary Care: An Analysis of Early-Career General Practitioners’ Consultations Involving Psoriasis
title_full Management of a Chronic Skin Disease in Primary Care: An Analysis of Early-Career General Practitioners’ Consultations Involving Psoriasis
title_fullStr Management of a Chronic Skin Disease in Primary Care: An Analysis of Early-Career General Practitioners’ Consultations Involving Psoriasis
title_full_unstemmed Management of a Chronic Skin Disease in Primary Care: An Analysis of Early-Career General Practitioners’ Consultations Involving Psoriasis
title_sort management of a chronic skin disease in primary care: an analysis of early-career general practitioners’ consultations involving psoriasis
publisher Mattioli1885
publishDate 2021
url https://doaj.org/article/5c3a150082844913ac07c6c782610efd
work_keys_str_mv AT sameerahnawaz managementofachronicskindiseaseinprimarycareananalysisofearlycareergeneralpractitionersconsultationsinvolvingpsoriasis
AT amandatapley managementofachronicskindiseaseinprimarycareananalysisofearlycareergeneralpractitionersconsultationsinvolvingpsoriasis
AT andrewdavey managementofachronicskindiseaseinprimarycareananalysisofearlycareergeneralpractitionersconsultationsinvolvingpsoriasis
AT miekelvandriel managementofachronicskindiseaseinprimarycareananalysisofearlycareergeneralpractitionersconsultationsinvolvingpsoriasis
AT alisonfielding managementofachronicskindiseaseinprimarycareananalysisofearlycareergeneralpractitionersconsultationsinvolvingpsoriasis
AT elizabethholliday managementofachronicskindiseaseinprimarycareananalysisofearlycareergeneralpractitionersconsultationsinvolvingpsoriasis
AT jeanball managementofachronicskindiseaseinprimarycareananalysisofearlycareergeneralpractitionersconsultationsinvolvingpsoriasis
AT irenapatsan managementofachronicskindiseaseinprimarycareananalysisofearlycareergeneralpractitionersconsultationsinvolvingpsoriasis
AT alyseberrigan managementofachronicskindiseaseinprimarycareananalysisofearlycareergeneralpractitionersconsultationsinvolvingpsoriasis
AT simonmorgan managementofachronicskindiseaseinprimarycareananalysisofearlycareergeneralpractitionersconsultationsinvolvingpsoriasis
AT neilspike managementofachronicskindiseaseinprimarycareananalysisofearlycareergeneralpractitionersconsultationsinvolvingpsoriasis
AT kristenfitzgerald managementofachronicskindiseaseinprimarycareananalysisofearlycareergeneralpractitionersconsultationsinvolvingpsoriasis
AT parkermagin managementofachronicskindiseaseinprimarycareananalysisofearlycareergeneralpractitionersconsultationsinvolvingpsoriasis
_version_ 1718425799760019456