Most Patients With Psoriasis Satisfied With Remote Consultations

A majority of patients with psoriasis and psoriatic arthritis believe that remote consultations will continue to be a part of their future disease management, but they want to have a choice of how and when those consultations are conducted, according to findings from a study published in Psychology, Health & Medicine.

Researchers conducted a cross-sectional, online survey to assess patients’ experiences with telephone and video consultations for psoriasis and psoriatic arthritis and provide patient insight on how to improve the remote consultations.

The participants were patients living in the United Kingdom who had a remote telephone or video consultation during the SARS-CoV-2 pandemic.

A total of 126 patients completed the survey, with 106 (84%) respondents living in England. Of the cohort, 116 individuals (92%) had a telephone consultation and 10 (8%) had a video consultation. A dermatologist was involved in 60 (48%) of the consultations.

About 78% of patients reported that they were satisfied with their consultation experience and 22% were not. In addition, 21% responded that they would be happy to have future remote consultations, 39% would agree to have a remote consultation but not for every consultation, and 18% preferred to alternate face-to-face and virtual consultations. Furthermore, 17% thought that remote consultations were acceptable during a pandemic only, and 5% did not want any further remote consultations.

The advantages of remote consultations cited by the responders included that they enabled continuity of care in a safe environment without increasing anxiety during the pandemic; remote consultations were also perceived as convenient and more efficient. The disadvantages that were noted included practical issues such as physical examination of skin and joints, the absence of nonverbal cues and emotions, some patients doubted the accuracy of remote clinical assessments and diagnoses, and others thought that telephone consultations were poorly scheduled.

Some patients preferred video appointments vs telephone consultations because they allowed a degree of physical examination and real-time discussion with clinicians, but most were not offered a video consultation. Respondents who did have the option or were able send photos before the appointment experienced poor video and picture quality.

A major criticism of remote consultations was that they did not feel personal, especially telephone consultations. Respondents suggested that clinicians read the patients’ medical records before the consultations to familiarize themselves with the patient’s circumstances, and the clinician should remember to introduce themselves.

Among several study limitations, the diagnoses were self-reported and most participants were from England and had telephone consultations. Also, the survey did not obtain demographic data, and the cross-sectional design prevented assessment of patients’ views of remote consultations during subsequent waves of the pandemic.

Study findings have implications for consultation skills training, as clinicians need to address psychological issues related to psoriatic diseases, noted the investigators.

“Video consultations could be offered to patients as an alternative option to face-to-face consultations for routine follow-up appointments,” stated the researchers. “Improvements in practice, especially further consultation skills training for clinicians, is recommended.”

Disclosure: Several of the study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

Reference

Hewitt RM, Urmston D, Mcateer H, Schofield J, Bundy C. A UK online survey exploring patient perspectives of remote consultations for managing psoriasis and psoriatic arthritis during the SARS-CoV-2 pandemic. Psychol Health Med. Published online August 8, 2022. doi:10.1080/13548506.2022.2104883