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Yee D, Kingston P, Lee K, Huang M, Peterson H, Korouri E, Armstrong AW. Shared decision-making and satisfaction with care in patients with psoriasis: A population-based study in the United States. J Am Acad Dermatol 2023; 89:920-926. [PMID: 37011814 DOI: 10.1016/j.jaad.2023.03.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 02/19/2023] [Accepted: 03/12/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND Shared decision-making (SDM) is a critical component of the patient-physician relationship. Although SDM has been reported to improve patient knowledge in other fields, it is still relatively unknown in dermatology. OBJECTIVE To determine the association between SDM and satisfaction with care among patients with psoriasis. METHODS Cross-sectional study using data from the 2014 to 2017 and 2019 Medical Expenditure Panel Survey. RESULTS A weighted total of 3,715,027 patients with psoriasis were identified. The average SDM score was 3.6 (of 4), and the average satisfaction with care score was 8.6 (of 10). Approximately 42% of the cohort reported having a high SDM (score, ≥3.9). Patients who had high SDM had, on average, 85% higher satisfaction with care (P < .001) after adjusting for covariates. LIMITATIONS The results of our study should be interpreted within the context of the Medical Expenditure Panel Survey database. The ability to measure SDM was limited by the 7 items from Medical Expenditure Panel Survey, which may not fully capture active participation in shared decision-making. CONCLUSION A majority of patients with psoriasis are not participating in highly SDM. It is important to construct a framework for carrying out SDM efficiently to enhance physician-patient communication and improve patient outcomes.
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Affiliation(s)
- Danielle Yee
- Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Paige Kingston
- Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Kathryn Lee
- Saint Louis University School of Medicine, Saint Louis, Missouri
| | - Margaret Huang
- Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Hannah Peterson
- Loma Linda University School of Medicine, Loma Linda, California
| | | | - April W Armstrong
- Keck School of Medicine, University of Southern California, Los Angeles, California.
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Hoelker S, Ninosu N, Buettner S, Peitsch WK, Schaarschmidt ML. Patient preferences for topical psoriasis treatments: a discrete choice experiment. J DERMATOL TREAT 2022; 33:2595-2604. [DOI: 10.1080/09546634.2022.2059052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Suna Hoelker
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Nadia Ninosu
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Sylvia Buettner
- Department for Biomathematics and Medical Statistics, Faculty of Medicine Mannheim of the University of Heidelberg, Mannheim, Germany
| | - Wiebke K. Peitsch
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Marthe-Lisa Schaarschmidt
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
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van der Kraaij GE, Vermeulen FM, Smeets PMG, Smets EMA, Spuls PI. The current extent of and need for shared decision making in atopic dermatitis and psoriasis in the Netherlands: an online survey study amongst patients and physicians. J Eur Acad Dermatol Venereol 2020; 34:2574-2583. [PMID: 32163645 PMCID: PMC7818257 DOI: 10.1111/jdv.16340] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 01/14/2020] [Indexed: 12/02/2022]
Abstract
Background In shared decision making (SDM), patients and physicians work together to choose the best treatment option for an individual patient. Atopic dermatitis (AD) and psoriasis are particularly suitable for SDM, considering that the best treatment option depends on a patient’s preferences and values (preference‐sensitive decisions). Currently, it is unknown to what extent SDM is applied in treatment decisions for these diseases in the Netherlands. Objectives Primary, to assess the current extent of SDM in AD and psoriasis in the Netherlands amongst patients and dermatologists. Secondary, to assess the degree to which patients and physicians endorse SDM, to explore which characteristics are related to their preference to be involved in SDM and to identify which barriers and facilitators for SDM they perceive. Methods Two similar online surveys, one for patients with AD or psoriasis and one for (resident) dermatologists, were carried out. The surveys comprised validated questionnaires (shared decision making questionnaire (SDM‐Q; range 0–100), Control Preference Scale) and study‐specific statements mainly regarding barriers and facilitators for SDM. Results The responses of 219 patients and 147 physicians were analysed. Dermatologists experienced significantly more SDM than patients (SDM‐Q 82 vs 55; P < 0.01). Most patients and dermatologists prefer to share treatment decisions. Mainly facilitators for SDM were perceived, including the positive perception of patients and dermatologists regarding SDM. The perceived barriers included lack of continuity of care by the same physician and lack of time. Conclusion Despite the dermatologists’ optimistic perspective, patients experience a limited extent of SDM and physicians should be aware of this gap. Improvement of SDM in AD and psoriasis is needed. The positive attitude of patients and dermatologists towards the process and outcome of SDM is important facilitators, while barriers were mainly perceived on an organizational level.
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Affiliation(s)
- G E van der Kraaij
- Department of Dermatology, Amsterdam Public Health, Infection and Immunity, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - F M Vermeulen
- Department of Dermatology, Amsterdam Public Health, Infection and Immunity, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - P M G Smeets
- Department of Dermatology, Amsterdam Public Health, Infection and Immunity, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - E M A Smets
- Department of Medical Psychology, Amsterdam Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - P I Spuls
- Department of Dermatology, Amsterdam Public Health, Infection and Immunity, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Navarrete-Dechent C, Aleissa S, Cordova M, Liopyris K, Sahu A, Rossi AM, Lee EH, Nehal KS. Management of complex head-and-neck basal cell carcinomas using a combined reflectance confocal microscopy/optical coherence tomography: a descriptive study. Arch Dermatol Res 2020; 313:193-200. [PMID: 32020324 DOI: 10.1007/s00403-020-02037-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 12/13/2019] [Accepted: 01/18/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Recently, a combined reflectance confocal microscopy (RCM)-optical coherence tomography (OCT) has been tested for the diagnosis of basal cell carcinoma (BCC). Evaluating the role of RCM-OCT in management of complex BCCs has not been studied. The objective of the study was to investigate the utility of a new combined RCM-OCT device in the evaluation and management of complex BCCs in a descriptive study. METHODS Prospective study of consecutive cases (July 2018-June 2019) of biopsy-proven 'complex' BCC defined as BCC in the head-and-neck area with multiple high-risk criteria such as large size in the mask area, multiple recurrences, and high-risk subtype. All cases were evaluated with a combined RCM-OCT device that provided simultaneous image viewing on a screen. Lesions were evaluated bedside with RCM-OCT according to previously described criteria. RESULTS Ten patients with complex head-and-neck BCCs had mean age of 73.1 ± 13.0 years. Six (60%) patients were males. Mean BCC clinical size was 1.9 ± 1.2 cm (range 0.6-4.0 cm). RCM detected residual BCC in 8 out of 10 cases (80%) and OCT detected residual BCC in all 10 cases (100%). Six BCCs (60%) had a depth estimate of > 1000 µm under OCT. In five cases, (50%) RCM-OCT imaging results led to a change/modification in BCC management. CONCLUSION The use of a combined RCM-OCT device may help in the evaluation of complex head-and-neck BCCs by guiding treatment selection and defining the extent of surgery.
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Affiliation(s)
- Cristian Navarrete-Dechent
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 16 E 60th Street, New York, NY, USA
| | - Saud Aleissa
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 16 E 60th Street, New York, NY, USA
| | - Miguel Cordova
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 16 E 60th Street, New York, NY, USA
| | - Konstantinos Liopyris
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 16 E 60th Street, New York, NY, USA
- University of Athens, Athens, Greece
| | - Aditi Sahu
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 16 E 60th Street, New York, NY, USA
| | - Anthony M Rossi
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 16 E 60th Street, New York, NY, USA
| | - Erica H Lee
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 16 E 60th Street, New York, NY, USA
| | - Kishwer S Nehal
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 16 E 60th Street, New York, NY, USA.
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Handling group decision-making model with incomplete hesitant fuzzy preference relations and its application in medical decision. Soft comput 2018. [DOI: 10.1007/s00500-018-3316-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Grossman SK, Schut C, Kupfer J, Valdes-Rodriguez R, Gieler U, Yosipovitch G. Experiences with the first eczema school in the United States. Clin Dermatol 2018; 36:662-667. [PMID: 30217280 DOI: 10.1016/j.clindermatol.2018.05.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Patient education programs are beneficial in the treatment of chronic diseases. In Germany, France, and other countries worldwide, educating children, adolescents, and adults plus the parents of children with atopic dermatitis (AD) leads to better coping with the skin disease, as well as to a reduction in the severity of the skin symptoms and signs. The results in Europe led to the idea to also establish an eczema school in the United States. In the style of the German eczema school, an eczema school was founded in 2014 at Temple University, Philadelphia, PA. Since then, a team consisting of a dermatologist, psychologist, nutritionist, and nurse practitioner has offered an eczema school to interested patients with AD and their families three times a year. This patient education program consists of three weekly 2-hour sessions, which address proper skin care, the itch-scratch cycle, healthy nutrition, and the role of stress in AD. The current review summarizes the first experiences with the education program in the United States.
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Affiliation(s)
- Shoshana K Grossman
- Department of Dermatology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA
| | - Christina Schut
- Institute of Medical Psychology, Justus Liebig University, Giessen, Germany
| | - Jörg Kupfer
- Institute of Medical Psychology, Justus Liebig University, Giessen, Germany
| | - Rodrigo Valdes-Rodriguez
- Department of Dermatology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA
| | - Uwe Gieler
- Department of Dermatology and Department of Psychosomatic Medicine and Psychotherapy, University Clinic, Giessen, Germany
| | - Gil Yosipovitch
- Department of Dermatology and Cutaneous Surgery and Itch Center, Miller School of Medicine, University of Miami, Miami, Florida, USA.
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Gonzalez JM. Evaluating Risk Tolerance from a Systematic Review of Preferences: The Case of Patients with Psoriasis. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2018; 11:285-300. [DOI: 10.1007/s40271-017-0295-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Harun NA, Finlay AY, Piguet V, Salek S. Understanding clinician influences and patient perspectives on outpatient discharge decisions: a qualitative study. BMJ Open 2017; 7:e010807. [PMID: 28264822 PMCID: PMC5353329 DOI: 10.1136/bmjopen-2015-010807] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 12/02/2016] [Accepted: 01/17/2017] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To observe the influences on clinicians when discharging patients, to explore patients' perspectives concerning their discharge or follow-up decision and to identify what patients think is important for clinicians to consider when taking a discharge decision. DESIGN Qualitative study involving observations of consultations and semistructured interviews with outpatients. SETTING National Health Service outpatient clinics at a university hospital secondary referral centre. PARTICIPANTS 64 consultations were observed followed by 56 interviews with patients aged over 18 years. MAIN OUTCOME MEASURE Analysis of patients' perspectives and expectations concerning whether or not they were discharged. RESULTS 25 types of influences were observed to be influencing the discharge decision process. All 31 discharged patients appeared to accept the clinicians' decision; however, 10 (22%) of those patients later expressed disappointment. Patients' discontent was due to perceived clinicians' uncertainty in diagnosis (patients mentioning=2), poor acceptance of the diagnosis (2), disease not 'cured' (4), differing perception on medical needs (2), lack of concern for job demands (1), felt uninvolved in the decision-making (4), feeling rushed (3), prolonged open appointment (2), pushed to seek private care due to healthcare budget constraints (2), language barrier (1) and not keen to continue follow-up with general practitioner (2). Patients were happy when there was certainty of the diagnosis (19), clear treatment plan (16), advised on treatment side effects (7), given a contact number if symptoms recurred (4), considering their travelling and job demands (3). CONCLUSIONS This study highlights the importance of accurately perceiving patients' perspectives in ensuring the appropriateness of outpatient discharge. There was a disparity between patients' and clinicians' perception on what was an appropriate discharge. This included discrepancies concerning diagnostic certainties, private healthcare as an alternative, need for easy reaccess and choice of words surrounding discharge. Medical education should include handling these issues.
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Affiliation(s)
- N A Harun
- Division of Infection and Immunity, Department of Dermatology and Wound Healing, School of Medicine, Cardiff University, Cardiff, UK
| | - A Y Finlay
- Division of Infection and Immunity, Department of Dermatology and Wound Healing, School of Medicine, Cardiff University, Cardiff, UK
| | - V Piguet
- Division of Infection and Immunity, Department of Dermatology and Wound Healing, School of Medicine, Cardiff University, Cardiff, UK
| | - S Salek
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
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Massanet S, Vicente Riera J, Torrens J, Herrera-Viedma E. A model based on subjective linguistic preference relations for group decision making problems. Inf Sci (N Y) 2016. [DOI: 10.1016/j.ins.2016.03.040] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Ali F, Aslam A, Lear J. Sunscreen adherence: proffer patient preference. Br J Dermatol 2014; 171:1567. [DOI: 10.1111/bjd.13136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- F.R. Ali
- Dermatology Centre; University of Manchester; Salford Royal NHS Foundation Trust; Manchester Academic Health Science Centre; Manchester M6 8HD U.K
| | - A. Aslam
- Dermatology Centre; University of Manchester; Salford Royal NHS Foundation Trust; Manchester Academic Health Science Centre; Manchester M6 8HD U.K
| | - J.T. Lear
- Dermatology Centre; University of Manchester; Salford Royal NHS Foundation Trust; Manchester Academic Health Science Centre; Manchester M6 8HD U.K
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Affiliation(s)
- A. Anstey
- Aneurin Bevan University Health Board Royal Gwent Hospital Cardiff Road Newport Gwent NP20 2UB U.K
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