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A framework for improving the quality of care for people with psoriasis
Author(s) -
Augustin M.,
AlvaroGracia J.M.,
Bagot M.,
Hillmann O.,
van de Kerkhof P.C.M.,
Kobelt G.,
Maccarone M.,
Naldi L.,
Schellekens H.
Publication year - 2012
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/j.1468-3083.2012.04576.x
Subject(s) - medicine , psoriasis , quality (philosophy) , dermatology , epistemology , philosophy
SummaryA lack of national guidelines in some countries and lack ofconsensus amongst those that do exist in others is problematic.Specically, poor and inconsistent advice on initiating and opti-mising therapeutic interventions is a barrier to improving out-comes. While European guidelines can help to ll the gap incountries without national guidelines, their role should primar-ily be to strengthen and harmonise existing guidelines, and toprovide a framework for the development of new nationalguidelines. They therefore need to lead the provision of advicethat is not given in existing guidelines. Limited awareness ofguidelines and increasing pressures on patient consultation can Figure 5 The concept of cumulative life course impairment(CLCI) in psoriasis. 22 CLCI results from an interaction betweenthe burden of stigmatisation, physical and psychological co-mor-bidities; and coping strategies and external factors. Signicantimpairment may occur in patients with ineffective coping strate-gies and limited social support, even if they have a small burden.This impairment may be less in patients with effective copingstrategies and strong social support networks, even if the bur-den is large. (Figure adapted from Kimball 2010.)