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...
Guardado en:
| Autores principales: | , , , , , , , , , , , , |
|---|---|
| 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 |