Implementation of the PsoWell™ Model for the Management of People with Complex Psoriasis
DOI:
https://doi.org/10.2340/00015555-3802Keywords:
psoriasis, psychodermatology, medical education, qualitative researchAbstract
The Psoriasis and Well-being (PsoWell)™ training programme, incorporating motivational interviewing, improves clinicians’ knowledge and skills to manage complex psoriasis, including behaviour change. The aims of this study were to deliver the PsoWell™ training programme to dermatology specialists, and to evaluate the acceptability and feasibility of implementing the PsoWell™ model across dermatology services. Framework analysis of 19 qualitative semi-structured interviews was performed, following delivery of nine, 1-day PsoWell™ training days involving 119 participants. Two themes were identified: “Perceptions and Priorities” and “Awareness”, sub-divided into: “Awareness Not Competence” and “Increasing Awareness”. The PsoWell™ model was found to be acceptable and feasible to implement across dermatology settings. Participants were more skilled and motivated to address psychological issues, including behaviour change, but wanted further training to ensure competency. The trainees claimed that scepticism among some colleagues regarding whole-patient management might prevent uptake. Data showing the impact on health outcomes are needed and might overcome scepticism. Remote consultation could adopt the PsoWell™ approach.
Downloads
References
Parisi R, Iskandar IYK, Kontopantelis E, Augustin M, Griffiths CEM, Ashcroft DM. National, regional, and worldwide epidemiology of psoriasis: systematic analysis and modelling study. BMJ 2020; 369: m1590.
DOI: https://doi.org/10.1136/bmj.m1590
Takeshita J, Grewal S, Langan SM, Mehta NN, Ogdie A, Van Voorhees AS, et al. Psoriasis and comorbid diseases: epidemiology. J Am Acad Dermatol 2017; 76: 377-390.
DOI: https://doi.org/10.1016/j.jaad.2016.07.064
Manolis AA, Manolis TA, Melita H, Mandolis AS. Psoriasis and cardiovascular disease: the elusive link. Int Rev Immunol 2019; 38: 33-54.
DOI: https://doi.org/10.1080/08830185.2018.1539084
Nelson PA, Barker Z, Griffiths CEM, Cordingley L and Chew-Graham CA. 'On the surface': a qualitative study of GPs' and patients' perspectives on psoriasis. BMC Fam Pract 2013; 14: 158.
DOI: https://doi.org/10.1186/1471-2296-14-158
Nelson PA, Kane K, Chisholm A, Pearce CJ, Keyworth C, Rutter MK, et al. 'I should have taken that further' - missed opportunities during cardiovascular risk assessment in patients with psoriasis in UK primary care settings: a mixed-methods study. Health Expect: Int J Pub Partic Health Care Health Pol 2014; 19: 1121-1137.
DOI: https://doi.org/10.1111/hex.12404
Smith CH, Barker, JNWN. Psoriasis and its management. BMJ 2006; 33: 380-384.
DOI: https://doi.org/10.1136/bmj.333.7564.380
Michie S, van Stralen MM, West R. The BC wheel: a new method for characterising and designing BC interventions. Implement Sci 2011; 6: 42.
DOI: https://doi.org/10.1186/1748-5908-6-42
Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M. Developing and evaluating complex interventions: the new medical research council guidance. Br Med J 2008; 337: a16555.
DOI: https://doi.org/10.1136/bmj.a1655
Qureshi AA, Awosika O, Baruffi F, Rengifo-Pardo M, Ehrlich A. Psychological therapies in management of psoriatic skin disease: a systematic review. Am J Clin Dermatol 2019; 20: 607-624.
DOI: https://doi.org/10.1007/s40257-019-00437-7
Gist D L, Bhushan R, Hamarstrom E, Sluka P, Presta CM, Thompson JS, et al. Impact of a performance improvement CME activity on the care and treatment of patients with psoriasis. Am Acad Dermatol 2014; 72: 516-522.
DOI: https://doi.org/10.1016/j.jaad.2014.11.010
Prinsen CAC, Spuls PI, Lindeboom R, Sprangers MAG, de Rie MA, de Korte J. The efficacy of a health-related quality-of-life intervention during 48 weeks of biologic treatment of patients with moderate to severe psoriasis: results of a multicentre randomized controlled trial. Brit Assoc Dermatol 2015; 173: 1091-1094.
DOI: https://doi.org/10.1111/bjd.13906
Miller WR, Rollnick S. What is motivational interviewing? Behav Cognit Psychoth 1995; 23: 325-334.
DOI: https://doi.org/10.1017/S135246580001643X
Szczekala K, Wiktor K, Kanadys K, Wiktor H. Benefits of motivational interviewing application for patients and healthcare professionals. Pol J Pub Health 2019; 128: 170-173.
DOI: https://doi.org/10.2478/pjph-2018-0034
Frost H, Campbell P, Maxwell M, O'Carroll RE, Dombrowski SU, Williams B, et al. Effectiveness of motivational interviewing on adult BC in health and social care settings: a systematic review of reviews. PLOS One 2018; 13: e0204890.
DOI: https://doi.org/10.1371/journal.pone.0204890
Khoury LR, Moller T, Zachariae C, Correll H, Jorgensen NB, Pedersen C, et al. A prospective, clinical non-randomised controlled trial of individualised, nurse-led patient-centred intervention of patients with psoriasis (research letter). Br J Dermatol 2019; 180: 1244-1245.
DOI: https://doi.org/10.1111/bjd.17585
Chisholm A, Nelson PA, Pearce CJ, Littlewood AJ, Kane K, Henry AL et al. Motivational interviewing-based training enhances clinicians' skills and knowledge in psoriasis: findings from the PsoWell study. Br J Dermatol 2017; 176: 677-686.
DOI: https://doi.org/10.1111/bjd.14837
Malterud K, Siersma VD, Guassora AD. Sample size in qualitative interview studies: guided by information power. Qual Health Res 2016; 26: 1753-1760.
DOI: https://doi.org/10.1177/1049732315617444
Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006; 3: 77-101.
DOI: https://doi.org/10.1191/1478088706qp063oa
Gale NK, Heath G, Cameron E, Rashid S, Redwood S. Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med Res Methodol 2013; 13: 117.
DOI: https://doi.org/10.1186/1471-2288-13-117
Sekhon M, Cartwright M, Francis JJ. Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework. BMC Health Serv Res 2017; 17: 88.
DOI: https://doi.org/10.1186/s12913-017-2031-8
Chisholm A, Nelson PA, Pearce CJ, Keyworth C, Griffiths CEM, Cordingley L, et al. The role of personal models in clinical management: Exploring health care providers' beliefs about psoriasis. Br J Health Psychol 2015; 21: 114-134.
DOI: https://doi.org/10.1111/bjhp.12148
Nguyen TV, Hong J, Prose NS. Compassionate care: enhancing physician-patient communication and education in dermatology: part I: patient-centered communication. J Am Acad Dermatol 2013; 68: 362-363.
DOI: https://doi.org/10.1016/j.jaad.2012.10.059
James Lind Alliance. Psoriasis Priority Setting Partnership. [Accessed 2020 June 4]. Available from: http://www.jla.nihr.ac.uk/priority-setting-partnerships/psoriasis/.
NHS Digital. Coronavirus (COVID-19): shielded patient list. [Accessed 2020 October 1]. Available from: https://digital.nhs.uk/coronavirus/shielded-patient-list.
Additional Files
Published
How to Cite
License
Copyright (c) 2021 Rachael M. Hewitt, Rachael L. Pattinson, Lis Cordingley, Christopher E.M. Griffiths, C. Elise Kleyn, Helen McAteer, Julia Schofield, Chris Bundy
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All digitalized ActaDV contents is available freely online. The Society for Publication of Acta Dermato-Venereologica owns the copyright for all material published until volume 88 (2008) and as from volume 89 (2009) the journal has been published fully Open Access, meaning the authors retain copyright to their work.
Unless otherwise specified, all Open Access articles are published under CC-BY-NC licences, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for non-commercial purposes, provided proper attribution to the original work.
