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. 2024 Nov 16:18:2325-2335.
doi: 10.2147/PPA.S489731. eCollection 2024.

Defining the Care Pathway in Patients with Psoriasis and Atopic Dermatitis

Montserrat Masip #  1   2 , Neus Pagès-Puigdemont #  1   2 , Anna López-Ferrer #  2   3 , Héctor David de Paz #  4 , Esther Serra-Baldrich #  2   3 , Lluís Puig #  2   3 , Pau Riera #  1   2
Affiliations

Defining the Care Pathway in Patients with Psoriasis and Atopic Dermatitis

Montserrat Masip et al. Patient Prefer Adherence. .

Abstract

Purpose: This study aims to map the clinical pathway for psoriasis and atopic dermatitis (AD) in a tertiary hospital to better understand patient needs and experiences, thereby suggesting improvements in patient-centered care.

Methods: A mixed-method approach was utilised involving a literature review, a questionnaire for healthcare professionals (HCPs), and two focus groups (one with HCPs and the other with patients with psoriasis or AD). Ethical approvals were obtained, and informed consent was acquired from all participants.

Results: Patients and HCPs identified significant delays in the pre-diagnosis phase, extending up to five years for psoriasis and three years for AD, adversely affecting the timely initiation of effective treatment. In addition, there were reported difficulties in obtaining appointments during flares, a lack of dermatologic emergencies, a need to increase human resources and physical space, and a need for telematic consultations for urgent cases. Discrepancies between HCPs' perceptions and patients' experiences highlighted unmet needs, particularly in primary care settings and emergency departments. Several strengths were also identified, including satisfactory experience in dermatology, the hospital's high level of specialisation in the management of complex patients, optimal communication between services, consideration of patient preferences, and proper advice on hospital pharmacy care and administration support of treatment and adherence monitoring.

Conclusion: The findings underscore the necessity for interventions to reduce wait times and improve treatment immediacy and effectiveness post-diagnosis. The insights from this study can direct enhancements in patient management and satisfaction for individuals with psoriasis and AD.

Keywords: atopic dermatitis; care pathway; patient centered care; psoriasis.

Plain language summary

This study looked into how patients with psoriasis and atopic dermatitis (AD) are treated in a tertiary hospital. It focused on understanding the time it takes for patients to receive help and their satisfaction with the care received. By talking to doctors and patients, the researchers learned about the challenges in the early stages of these diseases and the delays in starting treatment or in the treatment process, among others. They discovered that these patients often wait too long before seeing a dermatologist, leading to a delay in treatment access. The study suggests that quicker diagnosis and treatment could improve how these conditions are managed and increase patient satisfaction.

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Conflict of interest statement

HD.P. is employee of Outcomes’10, and they have received payments from the sponsor for support on design and methodology, conduction of the study and medical writing. Prof. Dr. Anna López-Ferrer reports personal fees, non-financial support from AbbVie, personal fees from Amgen, personal fees from Almirall, personal fees from Boehringer Ingelheim, personal fees from Bristol Myers Squibb, personal fees from Janssen, personal fees from Lilly, personal fees from Leo-Pharma, personal fees from Novartis, personal fees from UCB, outside the submitted work. Dr Esther Serra-Baldrich reports personal fees, non-financial support from Leo Pharma, personal fees, non-financial support from Sanofi, personal fees from AbbVie, personal fees from Amgen, personal fees from Lilly, personal fees, non-financial support from Pfizer, personal fees from Incyte, personal fees from Almirall, outside the submitted work. Dr Lluís Puig reports grants, personal fees from AbbVie, during the conduct of the study; grants, personal fees from AbbVie, grants, personal fees from Almirall, grants, personal fees from Amgen, personal fees from Biogen, personal fees from Boehringer Ingelheim, personal fees from Bristol-Myers-Squibb, personal fees from Fresenius-Kabi, personal fees from Horizon, personal fees from Johnson&Johnson Innovative Medicine, grants, personal fees from Leo-Pharma, grants, personal fees from Lilly, personal fees from Novartis, personal fees from Samsung Bioepis, personal fees from Sandoz, personal fees from STADA, grants, personal fees from Sun Pharma, personal fees from Takeda, grants, personal fees from UCB, outside the submitted work; and Board member, International Psoriasis Council. The authors report no other conflict of interest in this work.

Figures

Figure 1
Figure 1
Detail of the pre-diagnosis phase of the care pathway for patients with psoriasis and AD.
Figure 2
Figure 2
Detail of the diagnosis phase of the care pathway for patients with psoriasis and AD.
Figure 3
Figure 3
Detail of the treatment phase of the care pathway for patients with psoriasis and AD.
Figure 4
Figure 4
Detail of the follow-up phase of the care pathway for patients with psoriasis and AD.
See this image and copyright information in PMC

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