Conversations on psoriasis–what patients want and what physicians can provide: a qualitative look at patient and physician expectations.
Humans; *Attitude of Health Personnel; Treatment Outcome; Dermatology/*organization & administration; *Communication; *Physician-Patient Relations; *Patient Satisfaction; Psoriasis/complications/psychology/*therapy
BACKGROUND: The role of the patient-physician relationship is a key issue in the management of lifelong, chronic conditions such as psoriasis, with each side bringing different perspectives. OBJECTIVE: To explore areas of congruence and disconnection in the relationship between psoriasis patients and dermatologists, with a focus on communication issues. METHODS: Three discussion group sessions were held in four centers across the United States with dermatologists, patients, and a follow-up of the dermatologists after watching the patient discussion. RESULTS: Patients want more information on psoriasis, fast treatments, clear expectations from the onset of therapy, and recognition of the emotional burden. Dermatologists found that patients do not receive or internalize adequate information and need further explanation of treatment regimens to increase compliance and patient satisfaction. LIMITATIONS: This was a qualitative study assessing the range of responses and was not a quantitative study designed to test specific hypotheses. The study may not be informative about the experiences of people with psoriasis not actively seeing a physician. CONCLUSIONS: Encounters between physicians and psoriasis patients can be enhanced by providing information on what psoriasis is, choosing fast-acting treatments that patients are willing to use, and providing written materials about the disease and treatment plan.
Uhlenhake Elizabeth E; Kurkowski David; Feldman Steven R
The Journal of dermatological treatment
2010
2010-01
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.3109/09546630903085328" target="_blank" rel="noreferrer noopener">10.3109/09546630903085328</a>
Dermatological patient safety: problems and solutions.
Humans; Communication; Dermatology/*standards; Patient Care Team; *Quality of Health Care; Medical Errors/*prevention & control; Safety Management/*organization & administration
BACKGROUND: Patient safety issues are the forefront of delivering effective quality healthcare. The fast pace and high volume of dermatology practice presents an opportunity for new research on error prevention and patient safety. OBJECTIVE: To identify areas of concern in patient safety to introduce starting points for new improvement projects in dermatology. METHODS: Aliterature search was performed using the PubMed database with the search terms 'patient safety' and 'quality of care'. The articles were categorized into three topics concerning patient safety research: safety in treatment and procedures received; safety issues related to facility infrastructure; and human resource management. RESULTS: Many issues identified as healthcare shortcomings such as wrong site surgery, patient misidentification, specimen errors, medication errors, communication failure, poor teamwork, healthcare worker management defects, and facility safety design problems were discussed in the literature. Each of these requires exploration with new safety initiatives for resolution. Alimitation included omitting pieces on occupational health and safety that could contribute to overall patient safety. Our search also included only data from one database. CONCLUSIONS: Patient safety is an ever-evolving process requiring continuous attention by practicing physicians including dermatologists, healthcare staff, patients, and research scholars to discover and implement new safety initiatives for overall healthcare improvement.
Uhlenhake Elizabeth; Feldman Steven R
The Journal of dermatological treatment
2010
2010-03
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.3109/09546630903085310" target="_blank" rel="noreferrer noopener">10.3109/09546630903085310</a>
Dermatosis neglecta: a series of case reports and review of other dirty-appearing dermatoses.
Adult; Female; Humans; Male; Middle Aged; Aged; Skin Care/*methods; Skin Diseases/*etiology/*therapy; 80 and over
Localized scaling and hyperpigmentation is a common finding and often a diagnostic and therapeutic challenge. Dermatosis neglecta (DN) represents a failure to adequately clean or scrub the skin, often in an area of hyperesthesia or prior trauma. We identified five cases of DN in two clinical practices in just the past few years. The condition is characterized by scrupulous avoidance of scrubbing, leading to a buildup of hyperpigmented, adherent, cornflake-like scales. An alcohol swabbing provided diagnosis and prompt clearing. Washing with soap and a washcloth also often leads to clearing. Dermatosis neglecta should be considered in the differential diagnosis of hyperpigmented scale; alcohol swabbing can serve as a diagnostic and therapeutic tool.
Lucas Jennifer L; Brodell Robert T; Feldman Steven R
Dermatology online journal
2006
2006-12
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Efficacy and safety of ustekinumab and etanercept for the treatment of psoriasis.
Humans; Treatment Outcome; Severity of Illness Index; Risk Assessment; Evidence-Based Medicine; Patient Selection; Ustekinumab; Antibodies; Anti-Inflammatory Agents/adverse effects/*therapeutic use; Etanercept; Immunoglobulin G/adverse effects/*therapeutic use; Immunosuppressive Agents/adverse effects/*therapeutic use; Psoriasis/*drug therapy/immunology; Receptors; Humanized; Monoclonal; Monoclonal/adverse effects/*therapeutic use; Tumor Necrosis Factor/*therapeutic use
IMPORTANCE OF THE FIELD: TNF-alpha inhibitors such as etanercept have been used for psoriasis for years. A fairly well defined efficacy and safety profile has developed. A new biologic agent, ustekinumab, an IL-12 and IL-23 inhibitor, has recently been released in the US for the treatment of moderate-to-severe psoriasis. The purpose of this article is to compare the efficacy and safety profiles of ustekinumab and etanercept. AREAS COVERED IN THIS REVIEW: We examined safety and efficacy data regarding ustekinumab and etanercept from clinical reports, a head-to-head trial, review articles, and databases and registries from the last 20 years. WHAT THE READER WILL GAIN: Evidence is reviewed about the efficacy for the treatment of psoriasis as well as the safety profiles for both agents, ustekinumab and etanercept. TAKE HOME MESSAGE: Both drugs have data to confirm efficacy and safety in patients with moderate-to-severe psoriasis in the short-term. The limited long-term data on the safety profile of ustekinumab requires careful judgment on the clinician's part, weighing well-defined benefits and potential unknown risks.
Uhlenhake Elizabeth E; Feldman Steven R
Expert opinion on biological therapy
2010
2010-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1517/14712598.2010.487061" target="_blank" rel="noreferrer noopener">10.1517/14712598.2010.487061</a>
Transcending the language barrier–creation of a multilingual dermatology website.
Humans; Needs Assessment; Health Education; *Dermatology; Program Development; *Language; Communication Barriers; Internet/*organization & administration; Medical Informatics/organization & administration
In a linguistically diverse society, healthcare professionals must overcome the daunting task of effectively communicating with patients who speak a different language. In effort to aid healthcare professionals and their patients, an on-line dermatology patient education resource was created with links to various skin related topics in over 30 languages. The development of the on-line resource, key features of the information available on the website, and limitations experienced during its creation are discussed in the article.
Ali Saba M; Hinckley Michael R; Feldman Steven R
Dermatology online journal
2007
2007-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).