Implementation of the PsoWell™ Model for the Management of People with Complex Psoriasis

Authors

  • Rachael M. Hewitt School of Healthcare Sciences, Cardiff University, CF24 0AB Cardiff, United Kingdom
  • Rachael L. Pattinson
  • Lis Cordingley
  • Christopher E.M. Griffiths
  • C. Elise Kleyn
  • Helen McAteer
  • Julia Schofield
  • Chris Bundy

DOI:

https://doi.org/10.2340/00015555-3802

Keywords:

psoriasis, psychodermatology, medical education, qualitative research

Abstract

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

Download data is not yet available.

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

2021-04-29

How to Cite

Hewitt, R. M., Pattinson, R. L., Cordingley, L., Griffiths, C. E., Kleyn, C. E., McAteer, H., … Bundy, C. (2021). Implementation of the PsoWell™ Model for the Management of People with Complex Psoriasis. Acta Dermato-Venereologica, 101(4), adv00445. https://doi.org/10.2340/00015555-3802