'In someone's clinic but not in mine' – clinicians' views of supporting lifestyle behaviour change in patients with psoriasis: a qualitative interview study. (20th October 2014)

• Record Type: Journal Article
• Authors: Nelson, P.A.; Keyworth, C.; Chisholm, A.; Pearce, C.J.; Griffiths, C.E.M.; Cordingley, L.; Bundy, C.
• Is Part Of: British journal of dermatology. Volume 171:Number 5(2014:Nov.)
• Page Start: 1116
• Page End: 1122
• Publication Date: 2014-10-20
• Subjects: Dermatology -- Periodicals; Skin -- Diseases -- Periodicals; 616.5
• DOI: 10.1111/bjd.13231
• Languages: English
• ISSNs: 0007-0963

Abstract

Summary: Background: Psoriasis is associated with significant comorbidity. Excess alcohol use, smoking and higher body mass index are all associated with psoriasis and may contribute to its onset and/or exacerbation. Lifestyle behaviour change (LBC) can be beneficial in the prevention of psoriasis and/or reduction of its severity. LBC techniques are effective when used properly by healthcare professionals. Objectives: It is unknown whether clinicians managing patients with psoriasis are familiar with LBC techniques or are confident to deliver LBC support in routine consultations. This study aimed to elicit the views and attitudes of healthcare professionals in primary and secondary care about addressing LBC for patients with psoriasis. Methods: We carried out in‐depth semistructured interviews with 23 dermatology specialist and general practitioners in English primary and secondary care settings stratified by discipline. Data were analysed using constant comparison and principles of Framework Analysis. Results: Clinicians recognized that lifestyle behaviours were important in psoriasis management, but believed it was not their role to facilitate LBC. Limited knowledge and skills to implement LBC principles and techniques underpinned their beliefs. Participants identified a need for training to enable the incorporation of LBC support activity into psoriasis services. Conclusions: Clinicians are not yet trained to support patients with psoriasis with effective LBC methods. Training in these methods is needed to enable healthcare professionals to assess and manage psoriasis better. Abstract : What's already known about this topic? Psoriasis is a common, long‐term inflammatory condition. Lifestyle factors that increase risk of psoriasis‐associated comorbidities, including cardiovascular disease, are common in this group. Lifestyle behaviour change (LBC) is beneficial for psoriasis outcomes, and effective when used properly by clinicians. What does this study add? Healthcare professionals managing patients with psoriasis are not currently trained to support LBC. Evidence‐based training for clinicians to address lifestyle factors is needed to ensure comprehensive psoriasis assessment and management.